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Contact Information

SUSQUEHANNA PHYSICIAN SERVICES
1100 GRAMPIAN BLVD
WILLIAMSPORT, PA17701-1909
 Phone: 570-326-8550
 Fax: 570-326-8551
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Undersea and Hyperbaric Medicine

2083P0011X 84 Physician/Preventive Medicine
 

Public Health & General Preventive Medicine

2083P0901X 84 Physician/Preventive Medicine
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
 

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for SUSQUEHANNA PHYSICIAN SERVICES · (Female)

NPI # 1992722524
Status Active
Credentials
Entity Individual
Enumeration date 07/17/2006
Last updated 09/28/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • PA Medicaid 0017300760199
  • PA Other 1580634 HIGHMARK BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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