Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Other names
Penn Medicine LGHP Roseville Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE KENNEDY (VICE PRESIDENT FINANCIAL SERVICES)
(717) 544-5010
Entity
Organization
Contact information
Practice address
51 PETERS RD STE 202, LITITZ, PA 17543-7685
(717) 569-6481
(717) 569-5213
Mailing address
51 PETERS RD STE 202, LITITZ, PA 17543-7685
(717) 569-6481
(717) 569-5213
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02404600
CAPITAL BLUE CROSS
PA
01
—
1001184
AMERIHEALTH MERCY
PA
05
—
1007327490226
—
PA
01
—
1508046
GATEWAY HEALTH PLAN
PA
01
—
4482843
AETNA NON-HMO
PA
01
—
51203
AETNA HMO
PA
01
—
5803
AETNA CAP OFFICE#
PA
01
—
874348
HIGHMARK BLUE SHIELD
PA
01
—
S1BX
GEISINGER HEALTH PLAN
PA
Enumeration date
02/22/2006
Last updated
03/27/2025
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