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General NPI Number Information
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NPI Number | 1659302743
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Entity Type | Organization
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Legal Business Name | SUSQUEHANNA GASTROENTEROLOGY ASSOCIATES, LTD
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 10 CHOATE CIRCLE
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City | MONTOURSVILLE
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State | PA
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Zip | 17754
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Country | US
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Telephone | 570-368-5566
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Fax | 570-368-5564
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Provider Business Mailing Address
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Address Line | 10 CHOATE CIRCLE
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City | MONTOURSVILLE
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State | PA
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Zip | 17754
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Country | US
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Telephone | 570-368-5566
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Fax | 570-365-5564
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HOLLY M. NEUHARD JR.
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Credential |
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Telephone | 570-368-5561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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