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NPI Code Detail

MEDICARE: GSLPG, INC

MEDICARE: GSLPG, INC
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
1207RC0000XCardiovascular Disease Physician

General Provider Information

NPI Number : 1952942245
Entity Type Code : Organization
Provider Name (Legal Business Name) : GSLPG, INC
Provider Business Mailing Address
First Line : 801 OSTRUM ST
Second Line :
City : BETHLEHEM
State : PA
Zip : 18015-1000
Country : US
Telephone Number : 484-526-4000
Fax Number :
Provider Business Practice Location Address
First Line : 100 PARAMOUNT BLVD
Second Line :
City : ORWIGSBURG
State : PA
Zip : 17961-2202
Country : US
Telephone Number : 272-639-1000
Fax Number :
Authorized Official
Title or Position : CVO SUPERVISOR
Name : SUSAN CHIAVAROLI
Credential :
Telephone Number : 484-526-3569
Provider Enumeration Date : 10/08/2019
Last Update Date : 10/08/2019

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