Organization · NPI-2
Susquehanna Physician Services
Psychiatry & Neurology, Neurology · Williamsport, PA
NPI number1609808716
StatusActive
Last updated in NPPESFeb 22, 2012
Details
- NPI
- 1609808716
- Entity type
- Organization (NPI-2)
- Legal business name
- Susquehanna Physician Services
- Organization subpart
- No
- Enumeration date
- Jul 7, 2006
- Last updated
- Feb 22, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | – | PA | Yes |
Other names
- Sps-Neurology (Other Name)
Practice location
700 High StreetWilliamsport, PA 17701-3198
Phone 570-321-2820 · Fax 570-321-2821
Mailing address
Po Box 31271201 Grampian Blvd
Williamsport, PA 17701-0127
Authorized official
Charles Santangelo
Executive Vp/Cfo
5703213171
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