Susquehanna Physician Services

NPI #1366470973 in Williamsport, Pennsylvania

Provider Information

NPI Number: 1366470973
Entity Type: Organization
Organization Name: Susquehanna Physician Services
Primary Specialty: Pediatrics
Enumeration Date: Jun 30, 2006
Last Updated: May 26, 2010

Practice Location

Address: 904 CAMPBELL ST
City: Williamsport
State: Pennsylvania
ZIP Code: 17701-3166
Phone: (570) 321-3100

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Pediatrics	208000000X	Primary

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