Healthcare Provider Details

I. General information

NPI: 1164336038
Provider Name (Legal Business Name): RANDALI MEDICAL ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 OREGON PIKE STE 301
LANCASTER PA
17601-4670
US

IV. Provider business mailing address

2207 OREGON PIKE STE 301
LANCASTER PA
17601-4670
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-4460
  • Fax: 717-560-4465
Mailing address:
  • Phone: 717-560-4460
  • Fax: 717-560-4465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. GAYLE SISBARRO
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 717-560-4460