1215087234 NPI number — GEISINGER CLINIC

Table of content: (NPI 1215087234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215087234 NPI number — GEISINGER CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEISINGER CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1215087234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 N ACADEMY AVE
Provider Second Line Business Mailing Address:
MC 49-52
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17822-4952
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-271-7421
Provider Business Mailing Address Fax Number:
570-271-7370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2813 INDUSTRIAL PARK RD
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
MIFFLINTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17059-9078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-436-8278
Provider Business Practice Location Address Fax Number:
717-436-8513
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZALESKI
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR DIRECTOR
Authorized Official Telephone Number:
570-271-7965

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PP414264L , 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: 2150184 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007535151357 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com