Healthcare Provider Details

I. General information

NPI: 1447252762
Provider Name (Legal Business Name): CENTRAL PENNSYLVANIA HEMATOLOGY & MEDICAL ONCOLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 12/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N 12TH ST UPPR LEVEL
LEMOYNE PA
17043-1428
US

IV. Provider business mailing address

50 N 12TH ST UPPR LEVEL
LEMOYNE PA
17043-1428
US

V. Phone/Fax

Practice location:
  • Phone: 717-737-5767
  • Fax: 717-737-5868
Mailing address:
  • Phone: 717-737-5767
  • Fax: 717-737-5868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: JOHN DANIEL CONROY JR.
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 717-599-5502