Organization
SUSQUEHANNA PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES SANTANGELO (EXECUTIVE VP/CFO)
(570) 321-3171
Entity
Organization
Contact information
Practice address
777 RURAL AVE, WILLIAMSPORT, PA 17701-3109
(570) 327-5566
(570) 327-4755
Mailing address
1201 GRAMPIAN BLVD, PO BOX 3127, WILLIAMSPORT, PA 17701-0127
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/15/2010
Last updated
01/15/2010
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