| Lycoming Internal Medicine, Inc. | |
|
1 Outlet Ln Ste 380 Lock Haven PA 17745-7814 | |
| (570) 398-1800 | |
| (570) 398-3320 |
| Full Name | Lycoming Internal Medicine, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Outlet Ln Ste 380, Lock Haven, Pennsylvania |
| Authorized Official Name and Position | Varsha R Patel (OFFICE MANAGER) |
| Authorized Official Contact | 5703981800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lycoming Internal Medicine, Inc. 1 Outlet Ln Ste 380 Lock Haven PA 17745-7814 Ph: (570) 398-1800 | Lycoming Internal Medicine, Inc. 1 Outlet Ln Ste 380 Lock Haven PA 17745-7814 Ph: (570) 398-1800 |
| NPI Number | 1861460867 |
|---|---|
| Provider Enumeration Date | 03/08/2006 |
| Last Update Date | 03/10/2022 |
| Medicare PECOS PAC ID | 3971574799 |
|---|---|
| Medicare Enrollment ID | O20040804001495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861460867 | NPI | - | NPPES |
| 0016518020003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Pravinchandra G Chapla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518935501 PECOS PAC ID: 1456495753 Enrollment ID: I20100225000038 |
| Provider Name | Rajesh J Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013985936 PECOS PAC ID: 7012094329 Enrollment ID: I20100225000424 |
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