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Individual

MRS. HEATHER GERSBACHER HAZLETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPA C

Contact information

Practice address
25 MONUMENT RD, SUITE 290, YORK, PA 17403-5060
(717) 812-4090
(717) 812-4092
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3026
(717) 851-1405
(717) 812-4092

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006869
NY
363A00000X
Physician Assistant
MA053963
PA
363AM0700X
Medical Physician Assistant
Primary
MA053963
PA
363AS0400X
Surgical Physician Assistant
006869
NY
363AS0400X
Surgical Physician Assistant
MA053963
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02199948
NY
01
1585197
GATEWAY-WMG
PA
01
2130941
HIGHMARK BLUE SHIELD
PA
Enumeration date
11/27/2006
Last updated
07/14/2016
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