# LANCASTER GENERAL MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Penn Medicine LGH Physical Medicine and Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194063743
- **Authorized official:** DENISE KENNEDY (VICE PRESIDENT FINANCIAL SERVICES)
- **Authorized official phone:** (717) 544-5010

## Contact information

- **Practice address:** 675 GOOD DR, LANCASTER, PA 17601-2426
- **Practice address phone:** (717) 544-3059
- **Practice address fax:** (717) 394-7501
- **Mailing address:** 675 GOOD DR, LANCASTER, PA 17601-2426
- **Mailing address phone:** (717) 544-3059
- **Mailing address fax:** (717) 394-7501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204R00000X | Electrodiagnostic Medicine Physician | — | NULL | — |
| 204R00000X | Electrodiagnostic Medicine Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/16/2013
- **Last updated:** 11/16/2020