Provider Demographics
NPI:1518939206
Name:BELFORD, RAPHAEL QUENTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAPHAEL
Middle Name:QUENTIN
Last Name:BELFORD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 FARM HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-8349
Mailing Address - Country:US
Mailing Address - Phone:717-761-3281
Mailing Address - Fax:
Practice Address - Street 1:16 FARM HOUSE LN
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-8349
Practice Address - Country:US
Practice Address - Phone:717-761-3281
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS000678L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA283099Medicare ID - Type UnspecifiedHGS ADMINISTRATORS NUMBER