Healthcare Provider Details

I. General information

NPI: 1629134036
Provider Name (Legal Business Name): RYAN SCOTT DELONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 GOOD DR
LANCASTER PA
17601-2426
US

IV. Provider business mailing address

555 N DUKE ST PO BOX 3555
LANCASTER PA
17602-2250
US

V. Phone/Fax

Practice location:
  • Phone: 717-295-3900
  • Fax: 717-391-9582
Mailing address:
  • Phone: 717-544-4950
  • Fax: 717-544-4149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD431220
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: