Provider Demographics
NPI:1861446908
Name:AVART, HERBERT N (DO)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:N
Last Name:AVART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 ATTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1028
Mailing Address - Country:US
Mailing Address - Phone:610-225-1899
Mailing Address - Fax:
Practice Address - Street 1:1999 SPROUL RD
Practice Address - Street 2:SUITE 10
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3508
Practice Address - Country:US
Practice Address - Phone:610-356-6250
Practice Address - Fax:610-353-2109
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004208L225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB40923Medicare UPIN
PA188457Medicare ID - Type Unspecified