| Sps-neurology | |
|
700 High Street Williamsport PA 17701-3198 | |
| (570) 321-2820 | |
| (570) 321-2821 |
| Full Name | Sps-neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 700 High Street, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Charles Santangelo (EXECUTIVE VP/CFO) |
| Authorized Official Contact | 5703213171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sps-neurology Po Box 3127 1201 Grampian Blvd Williamsport PA 17701-0127 Ph: () - | Sps-neurology 700 High Street Williamsport PA 17701-3198 Ph: (570) 321-2820 |
| NPI Number | 1609808716 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 02/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609808716 | NPI | - | NPPES |
| 0017300760176 | Medicaid | PA | |
| 50054352 | Other | PA | CAPITAL BLUECROSS |
| 1603595 | Other | PA | HIGHMARK BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Pennsylvania) | Primary |
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