Provider Demographics
NPI:1548244072
Name:NEVYAS, HERBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:J
Last Name:NEVYAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E CITY AVE
Mailing Address - Street 2:2 BALA PLAZA
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1501
Mailing Address - Country:US
Mailing Address - Phone:610-668-1192
Mailing Address - Fax:610-668-1509
Practice Address - Street 1:333 E CITY AVE
Practice Address - Street 2:2 BALA PLAZA
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1501
Practice Address - Country:US
Practice Address - Phone:610-668-2777
Practice Address - Fax:610-668-1509
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD006001E174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0053089000OtherKEYSTONE HEALTH PLAN
PA0006760100002Medicaid
PA005244OtherAETNA HMO
PA1283716OtherCIGNA HEALTH PLAN
PA358162OtherUNITED HEALTHCARE
PA31236EOtherKEYSTONE MERCY HP
PAA2279OtherMEDICARE ID TYPE UNSPECIFIED
NJ000760484OtherPA BLUE SHIELD
NJ0053089000OtherAMERIHEALTH HMO
PA180007834OtherMEDICARE ID TYPE UNSPECIFIED
NJ2446308Medicaid
PA10240MD006001EOtherHEALTH PARTNERS
PA0004411270OtherAETNA PPO
PA16072OtherPA BLUE SHIELD
NJ760484DCQMedicare PIN
PA16072OtherPA BLUE SHIELD
PA358162OtherUNITED HEALTHCARE