Healthcare Provider Details

I. General information

NPI: 1265336507
Provider Name (Legal Business Name): HAROLD ORANGE CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 NORTH ST
ATHENS PA
18810-1121
US

IV. Provider business mailing address

113 NORTH ST
ATHENS PA
18810-1121
US

V. Phone/Fax

Practice location:
  • Phone: 443-527-8071
  • Fax:
Mailing address:
  • Phone: 443-527-8071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0136001201
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: