Provider Demographics
NPI:1710482054
Name:GARY NALAVANY, LLC
Entity Type:Organization
Organization Name:GARY NALAVANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:NALAVANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-632-9955
Mailing Address - Street 1:PO BOX 1203
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-7203
Mailing Address - Country:US
Mailing Address - Phone:717-632-9955
Mailing Address - Fax:717-632-9893
Practice Address - Street 1:300 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-3709
Practice Address - Country:US
Practice Address - Phone:717-632-9955
Practice Address - Fax:717-632-9893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty