Individual
JEROME GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 544-5511
Mailing address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 544-5511
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD032172E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000405053
HIGHMARK BLUE SHIELD
PA
01
—
001518983
CBHNP
PA
05
—
001518983
—
PA
01
—
1150002
AETNA
PA
01
—
1577264
GATEWAY
PA
01
—
246547000
MAGELLAN
PA
01
—
3550126000
INDEPENDENCE BLUE CROSS
PA
01
—
50055865
CAPITAL BLUE CROSS
PA
01
—
P00003237
RAILROAD MEDICARE
PA
Enumeration date
06/23/2006
Last updated
10/07/2009
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