Provider Demographics
NPI:1588617534
Name:CAVORSI, JOSEPH PETER (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PETER
Last Name:CAVORSI
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 1:2201 RIDGEWOOD RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1189
Mailing Address - Country:US
Mailing Address - Phone:610-374-8841
Mailing Address - Fax:610-374-5745
Practice Address - Street 1:2201 RIDGEWOOD RD
Practice Address - Street 2:SUITE 190
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1189
Practice Address - Country:US
Practice Address - Phone:610-374-8841
Practice Address - Fax:610-374-5745
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039223L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01155701OtherKEYSTONE HEALTH PLAN CENT
PA116099OtherUNISON
PA93125OtherAETNA US HEALTHCARE
PA1051035OtherAMERIHEALTH MERCY
PA5135057002OtherCIGNA
PA0009202900004Medicaid
PA1503134OtherGATEWAY
PA01155701OtherCAPITAL BLUE CROSS
PA5135057002OtherCIGNA
PA116099OtherUNISON