Provider Demographics
NPI:1851363279
Name:ENDOSCOPY CENTER OF CENTRAL PENNSYLVANIA
Entity Type:Organization
Organization Name:ENDOSCOPY CENTER OF CENTRAL PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:WERKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-533-2224
Mailing Address - Street 1:1421 FISHBURN RD
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-9795
Mailing Address - Country:US
Mailing Address - Phone:717-835-2727
Mailing Address - Fax:
Practice Address - Street 1:1421 FISHBURN RD
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-9795
Practice Address - Country:US
Practice Address - Phone:717-835-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA087181Medicare PIN