Healthcare Provider Details

I. General information

NPI: 1245070341
Provider Name (Legal Business Name): LILY STRAKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RICHARDSON DR
LANCASTER PA
17603-4032
US

IV. Provider business mailing address

200 N 7TH ST
LEBANON PA
17046-5040
US

V. Phone/Fax

Practice location:
  • Phone: 717-392-8485
  • Fax: 717-397-5290
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: