Provider Demographics
NPI:1215171814
Name:MAY, WILLIAM JOESEPH (MED)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOESEPH
Last Name:MAY
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1135
Mailing Address - Country:US
Mailing Address - Phone:215-370-9886
Mailing Address - Fax:
Practice Address - Street 1:1623 S 11TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-1135
Practice Address - Country:US
Practice Address - Phone:215-370-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007279540001OtherMEDICAL ASSISTANCE