Provider Demographics
NPI:1073549390
Name:CENTRAL PENNSYLVANIA SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:CENTRAL PENNSYLVANIA SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLEISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-242-2525
Mailing Address - Street 1:27 SANDY LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1310
Mailing Address - Country:US
Mailing Address - Phone:717-242-2525
Mailing Address - Fax:
Practice Address - Street 1:27 SANDY LN
Practice Address - Street 2:SUITE 200
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1310
Practice Address - Country:US
Practice Address - Phone:717-242-2525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02438600OtherCAPITAL BLUE CROSS
PA463987OtherHIGHMARK BLUE SHIELD
PA463987OtherHIGHMARK BLUE SHIELD