Healthcare Provider Details

I. General information

NPI: 1528132610
Provider Name (Legal Business Name): STEPHEN DIAMANTONI & ASSOCIATES FAMILY PRACTICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 05/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 N FRANKLIN ST
LANCASTER PA
17602-2176
US

IV. Provider business mailing address

734 N FRANKLIN ST
LANCASTER PA
17602-2176
US

V. Phone/Fax

Practice location:
  • Phone: 717-295-7109
  • Fax: 717-295-7294
Mailing address:
  • Phone: 717-295-2323
  • Fax: 717-295-7294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD029374E
License Number StatePA

VIII. Authorized Official

Name: DR. STEPHEN G. DIAMANTONI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 717-295-2323