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General NPI Number Information
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NPI Number | 1750461406
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Entity Type | Organization
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Legal Business Name | HANOVER SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 400 YORK ST
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City | HANOVER
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State | PA
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Zip | 17331-3357
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Country | US
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Telephone | 717-637-8955
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Fax | 717-637-6376
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Provider Business Mailing Address
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Address Line | 400 YORK ST
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City | HANOVER
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State | PA
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Zip | 17331-3357
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Country | US
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Telephone | 717-637-8955
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Fax | 717-637-6376
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. THERESA A HAUGH
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Credential |
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Telephone | 717-677-4258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD016695E
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License Number State | PA
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