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Organization
NORTHERN LANCASTER COUNTY MEDICAL GROUP
Active
Organization
NORTHERN LANCASTER COUNTY MEDICAL GROUP
Active
Other names
Harvest Drive Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA MALIZIA (VICE PRESIDENT NLCMG)
(717) 738-0851
Entity
Organization
Contact information
Practice address
3469 HARVEST DR, GORDONVILLE, PA 17529-9401
(717) 768-3100
Mailing address
PO BOX 398, BROWNSTOWN, PA 17508-0398
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013977730020
—
PA
01
—
1893629
BLUE SHIELD
PA
01
—
DD6938
RAILROAD MEDICARE
PA
Enumeration date
08/20/2006
Last updated
03/11/2008
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