Organization
LYCOMING NEUROSURGICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODWAN K RAJJOUB M.D. (PRESIDENT)
(570) 326-2035
Entity
Organization
Contact information
Practice address
904 CAMPBELL ST, SUITE 104, WILLIAMSPORT, PA 17701-3166
(570) 326-2035
(570) 326-9220
Mailing address
904 CAMPBELL ST, SUITE 104, WILLIAMSPORT, PA 17701-3166
(570) 326-2035
(570) 326-9220
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD038209L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008460030003
—
PA
01
—
1528033651
DR RODWAN RAJJOUB NPI
PA
Enumeration date
01/17/2007
Last updated
12/29/2009
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