Provider Demographics
NPI:1558966788
Name:DESAFEY, DAVID II (RN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:DESAFEY
Suffix:II
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SPRINGCREST DR
Mailing Address - Street 2:
Mailing Address - City:CECIL
Mailing Address - State:PA
Mailing Address - Zip Code:15321-1164
Mailing Address - Country:US
Mailing Address - Phone:724-747-4538
Mailing Address - Fax:
Practice Address - Street 1:19 SPRINGCREST DR
Practice Address - Street 2:
Practice Address - City:CECIL
Practice Address - State:PA
Practice Address - Zip Code:15321-1164
Practice Address - Country:US
Practice Address - Phone:724-745-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN25951L163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty