Provider Demographics
NPI:1336477884
Name:BEAROFF, RICHARD JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:BEAROFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:320 KING OF PRUSSIA RD
Mailing Address - Street 2:STE 120 RADNOR MEDICAL ASSOC.
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087
Mailing Address - Country:US
Mailing Address - Phone:610-688-8801
Mailing Address - Fax:610-688-6776
Practice Address - Street 1:320 KING OF PRUSSIA RD
Practice Address - Street 2:RADNOR MEDICAL ASSOC.
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087
Practice Address - Country:US
Practice Address - Phone:610-688-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019365E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B-34634Medicare UPIN