Provider Demographics
NPI:1093781783
Name:LANCASTER SKIN CENTER PC
Entity Type:Organization
Organization Name:LANCASTER SKIN CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT LANCASTER SKIN CENTER PC
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:ANDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-560-6444
Mailing Address - Street 1:190 N POINTE BLVD
Mailing Address - Street 2:STE 1
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-560-6444
Mailing Address - Fax:717-569-1044
Practice Address - Street 1:190 N POINTE BLVD
Practice Address - Street 2:STE 1
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-560-6444
Practice Address - Fax:717-569-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA099338Medicare PIN