Provider Demographics
NPI:1760446439
Name:AZARVA, HARVEY LAURENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:LAURENCE
Last Name:AZARVA
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 1:921 W CHELTENHAM AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-3208
Mailing Address - Country:US
Mailing Address - Phone:215-635-4902
Mailing Address - Fax:215-635-2565
Practice Address - Street 1:921 W CHELTENHAM AVE
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-3208
Practice Address - Country:US
Practice Address - Phone:215-635-4902
Practice Address - Fax:215-635-2565
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022151E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1025977OtherKEYSTONE MERCY B
37280OtherAETNA
1025978OtherKEYSTONE MERCY C
8864099004OtherCIGNA
00544020001OtherKEYSTONE HPE
1026076OtherKEYSTONE MERCY A
PA1629552Medicaid
PA1629552Medicaid
1025978OtherKEYSTONE MERCY C