Healthcare Provider Details

I. General information

NPI: 1790942225
Provider Name (Legal Business Name): AMY C HANCOCK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N DUKE ST
LANCASTER PA
17602-2250
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 717-544-4940
  • Fax: 717-544-4149
Mailing address:
  • Phone: 717-544-4940
  • Fax: 717-544-4149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMD442716
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: