Provider Demographics
NPI:1326180654
Name:BRADLEY C NORFORD PHD PC
Entity Type:Organization
Organization Name:BRADLEY C NORFORD PHD PC
Other - Org Name:BRYN MAWR PSYCHOLOGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:NORFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-525-4828
Mailing Address - Street 1:PO BOX 893
Mailing Address - Street 2:
Mailing Address - City:SOUTHEASTERN
Mailing Address - State:PA
Mailing Address - Zip Code:19399-0893
Mailing Address - Country:US
Mailing Address - Phone:610-525-4828
Mailing Address - Fax:610-525-3216
Practice Address - Street 1:14 S BRYN MAWR AVENUE
Practice Address - Street 2:SUITE 205
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-525-4828
Practice Address - Fax:610-525-3216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA094237Medicare PIN