Individual
JASON L GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2106 HARRISBURG PIKE, SUITE 1, LANCASTER, PA 17601-2644
(717) 291-5931
(717) 291-5818
Mailing address
2106 HARRISBURG PIKE, SUITE 1, LANCASTER, PA 17601-2644
(717) 291-5931
(717) 291-5818
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD435382
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0178781
—
MA
05
—
102253052
—
PA
01
—
1022530520001
MA/PROMISE
PA
01
—
1022530520002
MA/PROMISE
PA
Enumeration date
08/04/2006
Last updated
07/08/2020
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