Individual
MAX A. YESALAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 HOSPITAL DR, LEWISBURG, PA 17837-9350
(570) 522-2000
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN518009-L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
081789
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024154190002
—
PA
01
—
11945331
CAQH
PA
01
—
121176
GEISINGER
PA
01
—
1585282
GATEWAY
PA
01
—
2082635
FIRST PRIORITY
PA
01
—
3633568000
IBC
PA
01
—
50081140
CAPITAL ADVANTAGE
PA
01
—
9358458
AETNA
PA
Enumeration date
10/14/2008
Last updated
12/16/2025
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