Organization
NORTH CENTRAL CARDIOVASCULAR AND THORACIC SURGEON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN K CERO (PRACTICE MANAGER)
(570) 567-1041
Entity
Organization
Contact information
Practice address
777 RURAL AVE, WILLIAMSPORT, PA 17701-3109
(570) 567-1041
(570) 567-1044
Mailing address
777 RURAL AVE, WILLIAMSPORT, PA 17701-3109
(570) 567-1041
(570) 567-1044
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018681950001
—
PA
01
—
1322883
BLUE SHIELD
PA
Enumeration date
11/08/2005
Last updated
08/22/2020
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