Healthcare Provider Details

I. General information

NPI: 1891756649
Provider Name (Legal Business Name): THE HEART GROUP OF LANCASTER GENERAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 HARRISBURG AVE
LANCASTER PA
17603-2964
US

IV. Provider business mailing address

217 HARRISBURG AVE
LANCASTER PA
17603-2964
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-8300
  • Fax: 717-544-8265
Mailing address:
  • Phone: 717-544-8300
  • Fax: 717-544-8265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LOUISE M GAYDON
Title or Position: PRACTICE MANAGER
Credential: RN
Phone: 717-544-8310