Provider Demographics
NPI:1992904007
Name:MEDIA PSYCHIATRIC SERVICES, LLC
Entity type:Organization
Organization Name:MEDIA PSYCHIATRIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANURADHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-478-1881
Mailing Address - Street 1:19 WATERFORD WAY
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-7251
Mailing Address - Country:US
Mailing Address - Phone:484-478-1881
Mailing Address - Fax:
Practice Address - Street 1:205 N MONROE ST # 2
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3052
Practice Address - Country:US
Practice Address - Phone:484-478-1881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047508L2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty