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General NPI Number Information
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NPI Number | 1952483034
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Entity Type | Organization
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Legal Business Name | GEORGE W. LIGHTY JR. MD, PHD, FACC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 551 W LANCASTER AVE SUITE 305
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City | HAVERFORD
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State | PA
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Zip | 19041-1419
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Country | US
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Telephone | 610-527-9001
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Fax | 610-527-9004
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Provider Business Mailing Address
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Address Line | 551 W LANCASTER AVE SUITE 305
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City | HAVERFORD
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State | PA
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Zip | 19041-1419
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Country | US
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Telephone | 610-527-9001
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Fax | 610-527-9004
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. MARIE ELIZABETH FOLK-LIGHTY
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Credential | RN, MSN
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Telephone | 610-527-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD045692L
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License Number State | PA
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