Organization
LEWISBURG CANCER CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NAREN SRIVASTAVA (ADMINISTRATOR)
(570) 374-8555
Entity
Organization
Contact information
Practice address
75 MEDICAL PARK DR, LEWISBURG, PA 17837-6343
(570) 374-8555
(570) 374-9933
Mailing address
1575 N OLD TRL, SELINSGROVE, PA 17870-8381
(570) 374-8555
(570) 374-9933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00196120600001
—
PA
Enumeration date
07/20/2006
Last updated
11/12/2010
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