Provider Demographics
NPI:1275573032
Name:MUNESES, TODD I (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:I
Last Name:MUNESES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-2560
Mailing Address - Fax:717-812-2569
Practice Address - Street 1:781 FAR HILLS DR
Practice Address - Street 2:STE 600
Practice Address - City:NEW FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:17349-9346
Practice Address - Country:US
Practice Address - Phone:717-812-2560
Practice Address - Fax:717-812-2569
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0714972084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA814652OtherPA BLUE SHIELD
PA01142502OtherCAPITAL BLUE CROSS
PA521505OtherBC/BS OF MD. CARE FIRST
PA260050917OtherMEDICARE RAILROAD
PA020344OtherVALUE OPTIONS
PA155527000OtherMAGELLAN
PA2170203OtherCIGNA BEHAVIORAL HEALTH
PA01801839Medicaid
PA462517OtherMAMSI
PA020344OtherVALUE OPTIONS
PA01801839Medicaid