Healthcare Provider Details

I. General information

NPI: 1023678067
Provider Name (Legal Business Name): LIZA GERGENTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HIGHLAND AVE
HANOVER PA
17331-2297
US

IV. Provider business mailing address

300 HIGHLAND AVE
HANOVER PA
17331-2297
US

V. Phone/Fax

Practice location:
  • Phone: 717-988-0000
  • Fax: 717-782-5716
Mailing address:
  • Phone: 717-988-0000
  • Fax: 717-782-5716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMT217858
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD476074
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: