Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Other names
Penn Medicine LGHP Diabetes & Endocrinology
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE A KENNEDY (VP FINANCIAL SERVICES)
(717) 544-5010
Entity
Organization
Contact information
Practice address
2112 HARRISBURG PIKE, SUITE 200, LANCASTER, PA 17601-2644
(717) 544-3059
(717) 544-3638
Mailing address
2112 HARRISBURG PIKE, SUITE 200, LANCASTER, PA 17601-2644
(717) 544-3059
(717) 544-3638
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003073
AMERIHEALTH MERCY HEALTH
PA
05
—
1007327490102
—
PA
01
—
116085
AETNA HMO
PA
01
—
1449920
HIGHMARK BLUE SHIELD
PA
01
—
1529799
GATEWAY HEALTH PLAN
PA
01
—
4699
GEISINGER HEALTH PLAN
PA
01
—
50008354
CAPITAL BLUE CROSS
PA
01
—
5991102
AETNA NON-HMO
PA
01
—
CD6279
RAILROAD MEDICARE
PA
Enumeration date
09/22/2005
Last updated
11/16/2020
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