Healthcare Provider Details

I. General information

NPI: 1528068137
Provider Name (Legal Business Name): DR. LEO GEORGE DOROZYNSKY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 NEW HOLLAND AVE
LANCASTER PA
17602-2287
US

IV. Provider business mailing address

802 NEW HOLLAND AVE
LANCASTER PA
17602-2287
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-3782
  • Fax: 717-560-3787
Mailing address:
  • Phone: 717-560-3782
  • Fax: 717-560-3787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD022640E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: