Provider Demographics
NPI:1457333676
Name:BILOFSKY, IRA L (MSW)
Entity Type:Individual
Prefix:MR
First Name:IRA
Middle Name:L
Last Name:BILOFSKY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 SENTRY PARKWAY, BUILDING #5
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2958
Mailing Address - Country:US
Mailing Address - Phone:215-661-9515
Mailing Address - Fax:888-415-1303
Practice Address - Street 1:325 SENTRY PARKWAY, BUILDING #5
Practice Address - Street 2:SUITE 200
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2958
Practice Address - Country:US
Practice Address - Phone:215-661-9515
Practice Address - Fax:888-415-1303
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-006995-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF38623Medicare UPIN
PA738623Medicare PIN