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General NPI Number Information
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NPI Number | 1053329979
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Entity Type | Organization
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Legal Business Name | NORTHERN LANCASTER COUNTY MEDICAL GROUP
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 808 PLEASANTVIEW DR
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City | EPHRATA
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State | PA
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Zip | 17522-1644
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Country | US
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Telephone | 717-733-6518
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Fax | 717-733-8613
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Provider Business Mailing Address
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Address Line | PO BOX 398
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City | BROWNSTOWN
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State | PA
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Zip | 17508-0398
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Country | US
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Telephone | 717-859-2038
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Fax | 717-859-2803
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Authorized Official
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Title or Position | VP NORTHERN LANC CO MEDICAL GROUP
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Name | CYNTHIA MALIZIA
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Credential |
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Telephone | 717-738-2280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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