Healthcare Provider Details

I. General information

NPI: 1568488757
Provider Name (Legal Business Name): RICHARD H. NIEMEYER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 E MAIN ST
LEOLA PA
17540-1964
US

IV. Provider business mailing address

146 E MAIN ST
LEOLA PA
17540-1964
US

V. Phone/Fax

Practice location:
  • Phone: 717-656-2141
  • Fax: 717-656-4986
Mailing address:
  • Phone: 717-656-2141
  • Fax: 717-656-4986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MS. EVETTE A VEGA-STECKLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 717-656-2141