Provider Demographics
NPI:1154666428
Name:HARRIGAN, VONCEL R SR
Entity Type:Individual
Prefix:MR
First Name:VONCEL
Middle Name:R
Last Name:HARRIGAN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 W CAYUGA ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-1905
Mailing Address - Country:US
Mailing Address - Phone:215-669-6325
Mailing Address - Fax:
Practice Address - Street 1:1501 W CAYUGA ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19140-1905
Practice Address - Country:US
Practice Address - Phone:215-669-6325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management