Provider Demographics
NPI:1801883970
Name:LANCASTER NEUROSCIENCE & SPINE ASSOCIATES
Entity type:Organization
Organization Name:LANCASTER NEUROSCIENCE & SPINE ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOWTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-569-5331
Mailing Address - Street 1:1671 CROOKED OAK DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4269
Mailing Address - Country:US
Mailing Address - Phone:717-569-5331
Mailing Address - Fax:717-569-4210
Practice Address - Street 1:1671 CROOKED OAK DR
Practice Address - Street 2:THE CTR FOR SPINE CARE AT LANCASTER NEUROSCIENCE & SPIN
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4207
Practice Address - Country:US
Practice Address - Phone:717-569-5331
Practice Address - Fax:717-569-4210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA15481501261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007359470010Medicaid
PA056497Medicare PIN