| Lcdocs LLC | |
|
33 W 3rd St Williamsport PA 17701-6523 | |
| (570) 429-3501 | |
| Not Available |
| Full Name | Lcdocs LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 33 W 3rd St, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Joseph Calabro (OWNER) |
| Authorized Official Contact | 7322120060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lcdocs LLC 66 W Gilbert St Tinton Falls NJ 07701-4947 Ph: (732) 212-0060 | Lcdocs LLC 33 W 3rd St Williamsport PA 17701-6523 Ph: (570) 429-3501 |
| NPI Number | 1407570534 |
|---|---|
| Provider Enumeration Date | 10/03/2022 |
| Last Update Date | 07/08/2024 |
| Certification Date | 07/08/2024 |
| Medicare PECOS PAC ID | 6608245386 |
|---|---|
| Medicare Enrollment ID | O20221220001798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407570534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Frank M Mazzotta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588618730 PECOS PAC ID: 1456392372 Enrollment ID: I20050520000022 |
| Provider Name | Donald L Tressler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518915107 PECOS PAC ID: 5597700997 Enrollment ID: I20050627000426 |
| Provider Name | Mark a Hampton |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1528072725 PECOS PAC ID: 4385640200 Enrollment ID: I20061016000452 |
| Provider Name | Bethany K Engel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629377015 PECOS PAC ID: 4789869298 Enrollment ID: I20110427000553 |
| Provider Name | Courtney Linn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659712628 PECOS PAC ID: 4981839024 Enrollment ID: I20131028001071 |
| Provider Name | Desiree Evon Tarr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922565845 PECOS PAC ID: 0143560474 Enrollment ID: I20190322000520 |
| Provider Name | Amy E Vanderwall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659836914 PECOS PAC ID: 0143558254 Enrollment ID: I20190828001210 |
| Provider Name | Helga Faust |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629696604 PECOS PAC ID: 7416372719 Enrollment ID: I20200804001188 |
| Provider Name | Melissa Bazydlo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285356410 PECOS PAC ID: 3577930510 Enrollment ID: I20221104001230 |
| Provider Name | Charlotte Dudek |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790494961 PECOS PAC ID: 6709250954 Enrollment ID: I20230330000118 |
| Provider Name | Theresa Snyder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760149694 PECOS PAC ID: 1355794710 Enrollment ID: I20240201001809 |
| Provider Name | Kelly Jean Grotzinger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659605418 PECOS PAC ID: 7719026046 Enrollment ID: I20241024000607 |
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