Provider Demographics
NPI:1538376538
Name:VAUSE, RICHARD CLINTON JR (PA-C, DHSC)
Entity type:Individual
Prefix:PROF
First Name:RICHARD
Middle Name:CLINTON
Last Name:VAUSE
Suffix:JR
Gender:M
Credentials:PA-C, DHSC
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Mailing Address - Street 1:8470 LIMEKILN PIKE
Mailing Address - Street 2:APT 724
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-2701
Mailing Address - Country:US
Mailing Address - Phone:267-627-2613
Mailing Address - Fax:
Practice Address - Street 1:136 DIAMOND ST
Practice Address - Street 2:KENSINGTON HOSPITAL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-1721
Practice Address - Country:US
Practice Address - Phone:215-426-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2015-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA 000373L363AM0700X
FLPA9103393363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical