Individual
DR. LON A OVEDOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD065759L
PA
207Q00000X
Family Medicine Physician
213618-1
NY
207Q00000X
Family Medicine Physician
MD065759L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080159990
RR MEDICARE NY PIN
NY
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE PIN
PA
01
—
GU039851
PA MEDICARE GROUP
PA
01
—
P00099237
RR MEDICARE PIN
PA
Enumeration date
11/29/2005
Last updated
02/27/2021
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