# PREMISE HEALTH OF PENNSYLVANIA MEDICAL, P.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harley Davidson Health Center- York
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710262530
- **Authorized official:** JON LEIZMAN M.D. (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 1425 EDEN RD, YORK, PA 17402-1507
- **Practice address phone:** (717) 852-6757
- **Practice address fax:** (717) 852-6506
- **Mailing address:** 16906 COLLECTI16906 COLLECTIONS CTR DR, CHICAGO, IL 60693-0169
- **Mailing address phone:** (717) 852-6757
- **Mailing address fax:** (717) 852-6506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/12/2011
- **Last updated:** 08/15/2022