Provider Demographics
NPI:1134200181
Name:OTOLARYNGOLOGY PHYSICIANS OF LANCASTER, LTD.
Entity type:Organization
Organization Name:OTOLARYNGOLOGY PHYSICIANS OF LANCASTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-735-1450
Mailing Address - Street 1:810 PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2762
Mailing Address - Country:US
Mailing Address - Phone:717-394-5088
Mailing Address - Fax:717-394-5590
Practice Address - Street 1:810 PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2762
Practice Address - Country:US
Practice Address - Phone:717-394-5088
Practice Address - Fax:717-394-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA017300Medicare ID - Type Unspecified