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11 S State St Ephrata PA 17522-2410 | |
(717) 733-4559 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 11 S State St, Ephrata, Pennsylvania |
Authorized Official Name and Position | Cynthia Malizia (VP NLCMG) |
Authorized Official Contact | 7177382280 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 398 Brownstown PA 17508-0398 Ph: (717) 859-2038 | 11 S State St Ephrata PA 17522-2410 Ph: (717) 733-4559 |
NPI Number | 1538107560 |
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Provider Enumeration Date | 06/03/2006 |
Last Update Date | 04/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538107560 | NPI | - | NPPES |
1013977730012 | Medicaid | PA | |
50051253 | Other | PA | BLUE CROSS |
7090090 | Other | PA | AETNA |
DD6938 | Other | PA | RR MEDICARE |
1746355 | Other | PA | BLUE SHIELD |
1517100 | Other | PA | GATEWAY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |