Susquehanna Physician Services

NPI #1013118389 in Williamsport, Pennsylvania

Provider Information

NPI Number: 1013118389
Entity Type: Organization
Organization Name: Susquehanna Physician Services
Primary Specialty: Allergy & Immunology
Enumeration Date: May 31, 2007
Last Updated: May 20, 2010

Practice Location

Address: 1705 WARREN AVE
Address 2: SUITE 201
City: Williamsport
State: Pennsylvania
ZIP Code: 17701-2664
Phone: (570) 320-7645

Authorized Official

Name: MR. CHARLES SANTANGELO
Title: EXECUTIVE VP AND CFO
Phone: (570) 321-3171

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics - Pediatric Allergy/Immunology — Pediatric Allergy/Immunology	2080P0201X
Pediatrics - Pediatric Pulmonology — Pediatric Pulmonology	2080P0214X
Allergy & Immunology	207K00000X	Primary

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