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Organization

LEBANON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN LEAHY (CHIEF FINANCIAL OFFICER)
(845) 235-6531
Entity
Organization

Contact information

Practice address
113 S 9TH ST, LEBANON, PA 17042-5108
(717) 376-1133
Mailing address
225 CROSSWAYS PARK DR, WOODBURY, NY 11797-2083

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary

Other

Enumeration date
06/15/2026
Last updated
06/15/2026
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