Healthcare Provider Details

I. General information

NPI: 1376504449
Provider Name (Legal Business Name): RENAISSANCE HEALTHCARE OF HERSHEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 02/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 ELIZABETHTOWN RD
HERSHEY PA
17033-9323
US

IV. Provider business mailing address

3003 ELIZABETHTOWN RD
HERSHEY PA
17033-9323
US

V. Phone/Fax

Practice location:
  • Phone: 717-835-0700
  • Fax: 717-835-0702
Mailing address:
  • Phone: 717-835-0700
  • Fax: 717-835-0702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS009344L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT008436L
License Number StatePA

VIII. Authorized Official

Name: DR. PAUL DAMION CURTIN
Title or Position: OWNER
Credential: D.O.
Phone: 717-835-0700