Provider Demographics
NPI:1962841080
Name:TIOGA HEALTH CARE PROVIDERS INC
Entity Type:Organization
Organization Name:TIOGA HEALTH CARE PROVIDERS INC
Other - Org Name:SUSQUEHANNA HEALTH ANESTHESIA AT SOLDIERS & SAILORS MEM HOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HILFIGER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:570-723-0100
Mailing Address - Street 1:22 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-1526
Mailing Address - Country:US
Mailing Address - Phone:570-724-2126
Mailing Address - Fax:570-724-2126
Practice Address - Street 1:32-36 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1840
Practice Address - Country:US
Practice Address - Phone:570-723-7764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAWA72013OtherWELLS