Provider Demographics
NPI:1578562021
Name:CADY, HERBERT M JR (MD)
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:M
Last Name:CADY
Suffix:JR
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 1:7056 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1826
Mailing Address - Country:US
Mailing Address - Phone:215-247-1996
Mailing Address - Fax:215-247-7504
Practice Address - Street 1:7056 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1826
Practice Address - Country:US
Practice Address - Phone:215-247-1996
Practice Address - Fax:215-247-7504
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013848E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026452OtherKEYSTONE MERCY
PA0055732001OtherIBC PROVIDER NUMBER
PA6524OtherAETNA
PA00586414OtherMEDICAL ASSISTANT
PA103614Medicare ID - Type Unspecified
PA1026452OtherKEYSTONE MERCY