Healthcare Provider Details

I. General information

NPI: 1619940541
Provider Name (Legal Business Name): SUSAN MARY BATOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 10/24/2019
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.
LANCASTER PA
17604
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-5511
  • Fax:
Mailing address:
  • Phone: 717-544-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMD041243E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD041243E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: