Healthcare Provider Details

I. General information

NPI: 1922061605
Provider Name (Legal Business Name): WINER & HARVEY SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 S 4TH ST
LEBANON PA
17042-6158
US

IV. Provider business mailing address

229 S 4TH ST
LEBANON PA
17042-6158
US

V. Phone/Fax

Practice location:
  • Phone: 717-273-3758
  • Fax: 717-272-1734
Mailing address:
  • Phone: 717-273-3758
  • Fax: 717-272-1734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MRS. DEBORAH J SIMPSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 717-273-3758