Provider Demographics
NPI:1215084223
Name:PAUL W GAFFNEY
Entity type:Organization
Organization Name:PAUL W GAFFNEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:GAFFNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:610-337-7155
Mailing Address - Street 1:491 ALLENDALE RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1426
Mailing Address - Country:US
Mailing Address - Phone:610-337-7155
Mailing Address - Fax:610-337-7111
Practice Address - Street 1:491 ALLENDALE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1426
Practice Address - Country:US
Practice Address - Phone:610-337-7155
Practice Address - Fax:610-337-7111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001755441OtherHIGHMARK BLUE SHIELD
PA2421829000OtherINDEPENDENCE BLUE CROSS
PA1005470OtherKEYSTONE MERCY
PA2421829000OtherAMERIHEALTH HMO
PA2421829000OtherAMERIHEALTH HMO
PA2421829000OtherINDEPENDENCE BLUE CROSS
PA=========OtherTAX ID