Provider Demographics
NPI:1851427926
Name:UROLOGICAL SPECIALISTS, LTD
Entity Type:Organization
Organization Name:UROLOGICAL SPECIALISTS, LTD
Other - Org Name:SISBARRO UROLOGICAL SPECIALISTS, LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SISBARRO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-569-7015
Mailing Address - Street 1:1655 B CROOKED OAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-735-1919
Mailing Address - Fax:717-560-6977
Practice Address - Street 1:1655 B CROOKED OAK DRIVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-735-1919
Practice Address - Fax:717-560-6977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UROLOGICAL SPECIALISTS, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-26
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-005165-L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty