Healthcare Provider Details

I. General information

NPI: 1457457970
Provider Name (Legal Business Name): EMG GROUP LTD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 HARRISBURG PIKE SUITE 302
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

2110 HARRISBURG PIKE SUITE 302
LANCASTER PA
17601-2644
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-3364
  • Fax: 717-544-3365
Mailing address:
  • Phone: 717-544-3364
  • Fax: 717-544-3365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID G POLIN
Title or Position: OWNER
Credential: MD
Phone: 717-544-3364