Healthcare Provider Details

I. General information

NPI: 1114971249
Provider Name (Legal Business Name): CENTRAL PA EMERGENCY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 RURAL AVE
WILLIAMSPORT PA
17701-3109
US

IV. Provider business mailing address

232 LAKESIDE DR
HORSHAM PA
19044-2319
US

V. Phone/Fax

Practice location:
  • Phone: 570-321-2000
  • Fax: 570-321-2018
Mailing address:
  • Phone: 215-442-5021
  • Fax: 215-957-2875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GERHARD C. SENULA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 570-321-2000