Provider Demographics
NPI:1528560943
Name:LANCASTER UROLOGY PC
Entity Type:Organization
Organization Name:LANCASTER UROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELVY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:RN MS
Authorized Official - Phone:717-723-4579
Mailing Address - Street 1:2106 HARRISBURG PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-723-4579
Mailing Address - Fax:717-735-3904
Practice Address - Street 1:175 MARTIN AVE STE 300
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1761
Practice Address - Country:US
Practice Address - Phone:717-393-1771
Practice Address - Fax:717-735-3904
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER UROLOGY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty