Provider Demographics
NPI: | 1255482089 |
---|---|
Name: | THE MILTON S. HERSHEY MEDICAL CENTER PHYSICIANS GROUP |
Entity Type: | Organization |
Organization Name: | THE MILTON S. HERSHEY MEDICAL CENTER PHYSICIANS GROUP |
Other - Org Name: | MSHMC-MULTI-SPECIALITY |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DEBORAH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BERINI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 717-531-8802 |
Mailing Address - Street 1: | PO BOX 858 |
Mailing Address - Street 2: | |
Mailing Address - City: | HERSHEY |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 17033-0858 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 717-531-1159 |
Mailing Address - Fax: | 717-531-0119 |
Practice Address - Street 1: | 500 UNIVERSITY DIVE |
Practice Address - Street 2: | |
Practice Address - City: | HERSHEY |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17033 |
Practice Address - Country: | US |
Practice Address - Phone: | 800-243-1455 |
Practice Address - Fax: | 717-531-7269 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-01-16 |
Last Update Date: | 2022-04-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | 135101 | 204C00000X, 204D00000X, 204F00000X, 207K00000X, 207KA0200X, 207KI0005X, 207L00000X, 207LA0401X, 207LP2900X, 207LP3000X, 207N00000X, 207ND0900X, 207P00000X, 207Q00000X |
207LC0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 204C00000X | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine, Sports Medicine | Group - Multi-Specialty | |
No | 204D00000X | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM | Group - Multi-Specialty | |
No | 204F00000X | Allopathic & Osteopathic Physicians | Transplant Surgery | Group - Multi-Specialty | |
No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
No | 207KA0200X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | Group - Multi-Specialty |
No | 207KI0005X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Clinical & Laboratory Immunology | Group - Multi-Specialty |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207LA0401X | Allopathic & Osteopathic Physicians | Anesthesiology | Addiction Medicine | Group - Multi-Specialty |
No | 207LC0200X | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | Group - Multi-Specialty |
No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
No | 207LP3000X | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology | Group - Multi-Specialty |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207ND0900X | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology | Group - Multi-Specialty |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | CG7732 | Other | MEDICARE RAILROAD |
PA | 1007452910073 | Medicaid | |
PA | 036517 | Medicare PIN |