Healthcare Provider Details

I. General information

NPI: 1942380993
Provider Name (Legal Business Name): COSMETIC SURGERY CENTER OF LANCASTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 HARRISBURG PIKE SUITE 210
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

2110 HARRISBURG PIKE SUITE 210
LANCASTER PA
17601-2644
US

V. Phone/Fax

Practice location:
  • Phone: 717-291-5863
  • Fax: 717-392-6915
Mailing address:
  • Phone: 717-291-5863
  • Fax: 717-392-6915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN FUHRMAN
Title or Position: OFFICE MANAGER
Credential: LPN
Phone: 717-291-5863