Provider Demographics
NPI:1457360471
Name:LEBANON ONCOLOGY & HEMATOLOGY ASSOC.
Entity Type:Organization
Organization Name:LEBANON ONCOLOGY & HEMATOLOGY ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-274-8873
Mailing Address - Street 1:220 S RAILROAD ST
Mailing Address - Street 2:P.O. BOX 312
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078
Mailing Address - Country:US
Mailing Address - Phone:717-838-6462
Mailing Address - Fax:717-838-5659
Practice Address - Street 1:4TH & WILLOW ST
Practice Address - Street 2:HYMAN S CAPLAN PAVILION
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046
Practice Address - Country:US
Practice Address - Phone:717-274-8875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPE133702207RH0003X
PA036017E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02789600OtherCAPITAL BLUE CROSS
PA573400OtherHIGHMARK BLUE SHIELD
E23232Medicare UPIN
PA573400OtherHIGHMARK BLUE SHIELD
C31247Medicare UPIN