Provider Demographics
NPI:1023042108
Name:RUMFIELD, DALTON L JR (MS)
Entity Type:Individual
Prefix:MR
First Name:DALTON
Middle Name:L
Last Name:RUMFIELD
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1005 BROOKSIDE RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9023
Mailing Address - Country:US
Mailing Address - Phone:610-366-9333
Mailing Address - Fax:610-366-9332
Practice Address - Street 1:1005 BROOKSIDE RD
Practice Address - Street 2:SUITE 330
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9023
Practice Address - Country:US
Practice Address - Phone:610-366-9333
Practice Address - Fax:610-366-9332
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC 000221101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA106721OtherUBH
PA1661416OtherAMERIHEALTH
PA293813OtherMANAGED HEALTH NETWORK
PA7085387OtherAETNA
PAMHS 504577OtherVALUE OPTIONS
PA2167859OtherCIGNA
PA03110701OtherCAPITAL BLUE CROSS