Provider Demographics
NPI:1760472823
Name:LANZILLO, JOSEPH H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:H
Last Name:LANZILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-741-8180
Mailing Address - Fax:717-741-8196
Practice Address - Street 1:460 N READING RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9606
Practice Address - Country:US
Practice Address - Phone:717-721-4840
Practice Address - Fax:717-738-3558
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY436992085R0001X
PAMD029390E2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010522530004Medicaid
KY7100013850Medicaid
KY7100013850Medicaid