Healthcare Provider Details
I. General information
NPI: 1922057629
Provider Name (Legal Business Name): THE CENTERS FOR ADVANCED UROLOGY LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2006
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2106 HARRISBURG PIKE STE 200
LANCASTER PA
17601-2644
US
IV. Provider business mailing address
PO BOX 3200
LANCASTER PA
17604-3200
US
V. Phone/Fax
- Phone: 717-393-1771
- Fax: 717-393-2782
- Phone: 717-393-1771
- Fax: 717-393-2782
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
R
SIEBER
Title or Position: PRESIDENT
Credential: MD
Phone: 717-393-1771