MEDICARE: JOANNE S RILL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	MD461288	PA

General Provider Information

NPI Number	:	1659614592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE S RILL MD

Provider Business Mailing Address
First Line	:	1650 CROOKED OAK DR STE 200
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-4278
Country	:	US
Telephone Number	:	717-569-3279
Fax Number	:	717-509-5297

Provider Business Practice Location Address
First Line	:	1650 CROOKED OAK DR STE 200
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-4278
Country	:	US
Telephone Number	:	717-569-3279
Fax Number	:	717-509-5297

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2013
Last Update Date	:	09/15/2022

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