Provider Demographics
NPI:1023053600
Name:HALFPENNY, COLLEEN PATRICIA (MD)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:PATRICIA
Last Name:HALFPENNY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 PHILMONT AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5321
Mailing Address - Country:US
Mailing Address - Phone:215-938-7878
Mailing Address - Fax:215-938-7985
Practice Address - Street 1:2755 PHILMONT AVE STE 140
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5321
Practice Address - Country:US
Practice Address - Phone:215-938-7878
Practice Address - Fax:215-938-7985
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064753207W00000X
CAA90678207W00000X
PAMD423462207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023793680001Medicaid
MDP00469002OtherR/R MEDICARE PROVIDER #
CA00A906780Medicaid
MD411381100Medicaid
MDCC3779OtherR/R/ MEDICARE GROUP #
CAI30159Medicare UPIN
PA130159Medicare UPIN
CA00A906780Medicare PIN
MD411381100Medicaid
CA00A906780Medicaid
PA171924V2Medicare PIN