Provider Demographics
NPI:1942380993
Name:COSMETIC SURGERY CENTER OF LANCASTER
Entity Type:Organization
Organization Name:COSMETIC SURGERY CENTER OF LANCASTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FUHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:717-291-5863
Mailing Address - Street 1:2110 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-291-5863
Mailing Address - Fax:717-392-6915
Practice Address - Street 1:2110 HARRISBURG PIKE
Practice Address - Street 2:SUITE 210
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-291-5863
Practice Address - Fax:717-392-6915
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLASTIC SURGERY ASSOC OF LANCASTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-16
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA028792Medicare PIN