Provider Demographics
NPI:1043954886
Name:CARDINAL TREATMENT CENTER LANCASTER, INC.
Entity Type:Organization
Organization Name:CARDINAL TREATMENT CENTER LANCASTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHKLYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-343-2772
Mailing Address - Street 1:96 LINWOOD PLAZA, RT 9W
Mailing Address - Street 2:RT 9W, SUITE 303
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1531 MONMOUTH DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8730
Practice Address - Country:US
Practice Address - Phone:516-343-2772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center