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General NPI Number Information
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NPI Number | 1710482054
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Entity Type | Organization
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Legal Business Name | GARY NALAVANY, LLC
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 03/28/2018
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Provider Practice Location Address
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Address Line | 300 FREDERICK ST
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City | HANOVER
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State | PA
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Zip | 17331-3709
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Country | US
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Telephone | 717-632-9955
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Fax | 717-632-9893
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Provider Business Mailing Address
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Address Line | PO BOX 1203
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City | HANOVER
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State | PA
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Zip | 17331-7203
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Country | US
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Telephone | 717-632-9955
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Fax | 717-632-9893
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY WILLIAM NALAVANY
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Credential | MD
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Telephone | 717-632-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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