| Penn Medicine Lgh Psychiatry | |
|
555 N Duke St Lancaster PA 17602-2250 | |
| (717) 544-5511 | |
| Not Available |
| Full Name | Penn Medicine Lgh Psychiatry |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 555 N Duke St, Lancaster, Pennsylvania |
| Authorized Official Name and Position | Denise Kennedy (VICE PRESIDENT FINANCIAL SERVICES) |
| Authorized Official Contact | 7175445010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penn Medicine Lgh Psychiatry 555 N Duke St Lancaster PA 17602-2250 Ph: (717) 544-5511 | Penn Medicine Lgh Psychiatry 555 N Duke St Lancaster PA 17602-2250 Ph: (717) 544-5511 |
| NPI Number | 1306961800 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 11/06/2020 |
| Certification Date | 11/06/2020 |
| Medicare PECOS PAC ID | 1254240039 |
|---|---|
| Medicare Enrollment ID | O20040413001146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306961800 | NPI | - | NPPES |
| 1365406 | Other | PA | HIGHMARK BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kathleen C Dougherty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811958895 PECOS PAC ID: 4587678982 Enrollment ID: I20060206000209 |
| Provider Name | Leopoldo M Vocalan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104038397 PECOS PAC ID: 6406041722 Enrollment ID: I20101112000267 |
| Provider Name | Jacqueline Hostetter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790098671 PECOS PAC ID: 8123214541 Enrollment ID: I20101124001003 |
| Provider Name | Michael D Bowen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861551806 PECOS PAC ID: 9830368679 Enrollment ID: I20110811000423 |
| Provider Name | Lisa Ellen Sjodin-feldman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023057890 PECOS PAC ID: 0648290445 Enrollment ID: I20111025000385 |
| Provider Name | Matthew Biever |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023227741 PECOS PAC ID: 7113173402 Enrollment ID: I20120801000578 |
| Provider Name | Kevin P Kalnoski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598016958 PECOS PAC ID: 0446495337 Enrollment ID: I20130325000464 |
| Provider Name | Zoe Selhi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437349586 PECOS PAC ID: 2264601251 Enrollment ID: I20140429001486 |
| Provider Name | Jonathan Small |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487896627 PECOS PAC ID: 4385866417 Enrollment ID: I20170406002338 |
| Provider Name | Whitney J.d Bakken |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275738890 PECOS PAC ID: 2860532223 Enrollment ID: I20180123003053 |
| Provider Name | Sajeeb Adhikary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700204609 PECOS PAC ID: 4183963630 Enrollment ID: I20190228001907 |
| Provider Name | Chinenyenwa Onyemaechi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396087052 PECOS PAC ID: 9234438433 Enrollment ID: I20191031000936 |
| Provider Name | Angela C Onwuanibe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083637441 PECOS PAC ID: 6901885490 Enrollment ID: I20200205002223 |
| Provider Name | Martina Majella Sobolesky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669099719 PECOS PAC ID: 5395158935 Enrollment ID: I20201229000064 |
| Provider Name | David Dawit Berhanu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811643935 PECOS PAC ID: 5799172037 Enrollment ID: I20220505000029 |
| Provider Name | Onyinye Ugorji |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487074324 PECOS PAC ID: 9335489582 Enrollment ID: I20220512001631 |
| Provider Name | Kara Salaga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396318788 PECOS PAC ID: 8921404153 Enrollment ID: I20220520001642 |
| Provider Name | Tyrone Bristol |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437150596 PECOS PAC ID: 8921083965 Enrollment ID: I20221215002966 |
| Provider Name | Connie Ling Koons |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699238667 PECOS PAC ID: 4486981941 Enrollment ID: I20230707002958 |
| Provider Name | Kathryn G Stroh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083495279 PECOS PAC ID: 1951745868 Enrollment ID: I20240220000430 |
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