Provider Demographics
NPI:1972838092
Name:PENNSYLVANIA PSYCHIATRIC INSTITUTE
Entity Type:Organization
Organization Name:PENNSYLVANIA PSYCHIATRIC INSTITUTE
Other - Org Name:PPI CRNPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PURTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-782-4742
Mailing Address - Street 1:409 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-782-3131
Mailing Address - Fax:
Practice Address - Street 1:307 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1621
Practice Address - Country:US
Practice Address - Phone:717-782-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty