Provider Demographics
NPI:1730463654
Name:LANCASTER GENERAL MEDICAL GROUP
Entity Type:Organization
Organization Name:LANCASTER GENERAL MEDICAL GROUP
Other - Org Name:LANCASTER GENERAL HEALTH PEDIATRIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BYORICK
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:717-544-4296
Mailing Address - Street 1:694 GOOD DR
Mailing Address - Street 2:SUITE 23
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2433
Mailing Address - Country:US
Mailing Address - Phone:717-544-0375
Mailing Address - Fax:717-544-0376
Practice Address - Street 1:694 GOOD DR
Practice Address - Street 2:SUITE 23
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-544-0375
Practice Address - Fax:717-544-0376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Multi-Specialty
No2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Multi-Specialty