Healthcare Provider Details

I. General information

NPI: 1073097945
Provider Name (Legal Business Name): DUANE B CAHILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 CENTRE TPKE STE 2
ORWIGSBURG PA
17961-9059
US

IV. Provider business mailing address

1209 CENTRE TPKE STE 2
ORWIGSBURG PA
17961-9059
US

V. Phone/Fax

Practice location:
  • Phone: 570-968-2949
  • Fax:
Mailing address:
  • Phone: 570-968-2949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number38063601
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: