1053351544 NPI number — GOHAR ARSLAN M.D.

Table of content: LEANNE EBALANG (NPI 1427890235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053351544 NPI number — GOHAR ARSLAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARSLAN
Provider First Name:
GOHAR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053351544
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
785 5TH AVE STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-4232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-263-9555
Provider Business Mailing Address Fax Number:
717-709-6529

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22 ST PAUL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-1036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-217-6020
Provider Business Practice Location Address Fax Number:
717-217-6939
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  0101239945 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X , with the licence number: MD061486L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7468752 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010285518 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201175 . This is a "ANTHEM BCBS PROVIDER #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 2158923 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12451812 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10012710 . This is a "OPTIMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5905720 . This is a "NC MEDICAID" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: P00330533 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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