SUSQUEHANNA PHYSICIAN SERVICES


Address: 471 Hepburn St, Suite 135, Williamsport, PA 17701-6122
Phone: 5705675425

SUSQUEHANNA PHYSICIAN SERVICES (NPI# 1417091794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417091794
Entity Type Organization
Organization Name SUSQUEHANNA PHYSICIAN SERVICES
Other Organization Name SUSQUEHANNA CENTER FOR LIVER DISEASE
Practice Address 471 Hepburn St
Suite 135
Williamsport
PA 17701-6122
Mailing Address 1205 Grampian Blvd
Po Box 3127
Williamsport
PA 17701-1978
Practice Telephone 5705675425
Practice Fax Number 5705675426
Enumeration Date 2007-02-19
Last Update Date 2007-10-18
Authorized Official Name MR. CHARLES SANTANGELO (EXECUTIVE VP/ CFO)
Authorized Official Telephone 5703213171
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RI0008X Internal Medicine
Specialization: Hepatology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PA HIGHMARK BLUE SHIELD 1515700 01

Other Provider/Organization Names

Other Name Type Code
Susquehanna Center for Liver Disease Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1033345533 Susquehanna Physician Services Nurse Practitioner 10 Shady Lane, Suite 201, Muncy, PA 17756-8807 2009-06-10
1477793172 Susquehanna Physician Services Physician Assistant 1201 Grampian Blvd Ste 1a, Williamsport, PA 17701-1965 2009-02-20
1780603837 Susquehanna Physician Services Obstetrics & Gynecology 2134 W 4th St, Williamsport, PA 17701-4344 2006-07-19
1083677868 Susquehanna Physician Services Internal Medicine 700 High Street, Williamsport, PA 17701-3198 2006-04-11
1467453878 Susquehanna Physician Services Clinic/Center 1112 Grampian Blvd, Williamsport, PA 17701-1909 2005-08-09
1578164943 Susquehanna Physician Services Podiatrist 2370 Old Turnpike Rd Ste 4, Lewisburg, PA 17837-6567 2020-11-03
1982205472 Susquehanna Physician Services Clinic/Center 416 S Main St Ste 1, Mansfield, PA 16933-1510 2020-11-03
1962018135 Susquehanna Physician Services Family Medicine 700 High St Fl 9, Williamsport, PA 17701-3100 2020-09-22
1992359798 Susquehanna Physician Services Emergency Medicine 700 High St, Williamsport, PA 17701-3100 2019-07-30
1689905606 Susquehanna Physician Services Nurse Practitioner 777 Rural Ave, Williamsport, PA 17701-3109 2010-01-15

Office Location

Street Address 471 HEPBURN ST
SUITE 135
City WILLIAMSPORT
State PA
Zip Code 17701-6122

Providers in the same location

NPI Name Taxonomy Address Enumeration
1891796389 Ralph H. Kaiser Pediatrics 471 Hepburn St, Williamsport, PA 17701-6122 2005-08-09
1578177416 Laura Bierly Dental Hygienist 471 Hepburn St, Williamsport, PA 17701-6122 2020-09-08
1427662378 Christa Leigh Tempesco Dental Hygienist 471 Hepburn St, Williamsport, PA 17701-6122 2020-09-08
1427606334 Melinda Margaret Flick Dental Hygienist 471 Hepburn St, Williamsport, PA 17701-6122 2019-09-04
1447808043 Nicole Kehoe Dental Hygienist 471 Hepburn St, Williamsport, PA 17701-6122 2019-08-28
1619531266 Lisa Mcclintock Pharmacist 471 Hepburn St, Williamsport, PA 17701-6122 2019-04-30
1386106680 Susquehanna Community Health and Dental Clinic, Inc Pharmacy 471 Hepburn St, Williamsport, PA 17701-6122 2019-04-04
1730671462 Sarah Updegraff Nurse Practitioner 471 Hepburn St, Williamsport, PA 17701-6122 2018-05-30
1821588997 Laura Farr Dental Hygienist 471 Hepburn St, Williamsport, PA 17701-6122 2018-05-15
1972003168 Marsha C Person Dental Hygienist 471 Hepburn St, Williamsport, PA 17701-6122 2018-02-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184267809 Charlene Angella Pitter Nurse Practitioner 170 Warren Ave, Williamsport, PA 17701 2019-10-25
1396395299 Susan E Fetzer Occupational Therapy Assistant Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 2019-09-13
1184280984 Craig Andrew Tuller Student in an Organized Health Care Education/Training Program Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 2019-05-16
1760048045 Michael Harvey Student in an Organized Health Care Education/Training Program 740 High St. Suite 4001, Williamsport, PA 17701 2019-05-13
1275196008 Olivia Fladmark Student in an Organized Health Care Education/Training Program Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 2019-04-17
1528551231 Mark Hampton Chiropractic Inc. Durable Medical Equipment & Medical Supplies 1111 East 3rd Street, Williamsport, PA 17701 2018-06-08
1548710882 Central Pennsylvania Rehabilitation Medicine, Inc Physical Medicine & Rehabilitation 460 River Ave Ste 1, Williamsport, PA 17701 2016-10-11
1376096784 Christine Kessler Physician Assistant One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 2016-08-02
1629440276 Matthew Ray Rebuck Specialist/Technologist 220 N Reach Rd, Williamsport, PA 17701 2015-10-22
1508237223 Neihl Williamson Physician Assistant 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 2015-10-08
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Taxonomy Information

Taxonomy Code 207RI0008X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hepatology

Taxonomy Definition

The discipline of Hepatology encompasses the structure, function, and diseases of the liver and biliary tract. The American Board of Internal Medicine considers Hepatology part of the subspecialty of gastroenterology. Physicians who identify themselves as Hepatologists usually, but not always, have been trained in gastrointestinal programs.
Notes: Training Programs, and/or Fellowships, Preceptorships: The American Association for the Study of Liver Diseases (AASLD) is the major professional society organized for physicians with an interest in Hepatology. A subcommittee of that organization has published guidelines for training programs in the 1992 November issue of Hepatology. Source: The American Board of Internal Medicine 9/1993 ACGME Accredited Residency Program Requirements: None

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1952943326 Reading Hospital Internal Medicine 219 N Broad St Fl 4, Philadelphia, PA 19107-1507 2019-10-17
1669663480 Shahid Masood Malik Internal Medicine 100 Hyman Pl, Apartment 310, Pittsburgh, PA 15213-4617 2007-08-06
1225061385 Block Medical Associates, PC Internal Medicine 385 William Pitt Way, Pittsburgh, PA 15238-1329 2006-07-09
1306476924 Tower Health Medical Group Internal Medicine 8835 Germantown Ave, Philadelphia, PA 19118-2718 2020-01-23
1730722711 Reading Hospital Internal Medicine 420 S 5th Ave, West Reading, PA 19611-2143 2019-10-23
1518449453 Temple Faculty Practice Plan Inc Internal Medicine 3401 N Broad St, Philadelphia, PA 19140-5103 2018-09-06
1780929240 Mina Shaker Internal Medicine 3401 N Broad St, Philadelphia, PA 19140-5103 2012-12-10
1366758187 Neha Agrawal Internal Medicine 3401 N Broad St, Philadelphia, PA 19140-5103 2010-08-31
1689839524 Dale V Sinker Md Ltd Internal Medicine 27 Foxfield Ct, Ambler, PA 19002-5225 2008-07-21
1235272659 Abdullah M. S. Al-osaimi Internal Medicine 3401 N Broad St, Philadelphia, PA 19140-5103 2007-02-15
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Competitor

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City WILLIAMSPORT
Zip Code 17701

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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