Provider Demographics
NPI:1437279395
Name:CUMBERLAND PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:CUMBERLAND PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-761-8332
Mailing Address - Street 1:20 ERFORD RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1163
Mailing Address - Country:US
Mailing Address - Phone:717-761-8332
Mailing Address - Fax:
Practice Address - Street 1:20 ERFORD RD
Practice Address - Street 2:SUITE 204
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1163
Practice Address - Country:US
Practice Address - Phone:717-761-8332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-01
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029087E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA121375OtherMC PTAN
PAA72691Medicare UPIN