Susquehanna Physician Services
Organization Active NPI Vascular Surgery Physician · Williamsport, PA
NPI 1962446971 · NPPES record last updated Sep 23, 2022
Key facts
- NPI
- 1962446971
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- Legal business name
- SUSQUEHANNA PHYSICIAN SERVICES
- Practice address
- 740 High St
Suite 3001
Williamsport, PA 17701-3102 - Phone
- (570) 321-2805
- Fax
- (570) 321-2806
- NPI assigned
- Jun 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Melissa Davis
- Title
- VP/Coo
- Phone
- (570) 320-7696
Practitioners 30
-
Karla Anderson, MD
-
Rupal Bandi, MD
-
Sarah Brown, DO
-
Rajoo Dhangana, M.D.
-
Gabrielle Renee Fries, PA-C
-
Jennifer Lynn Kissane, M.D.
-
Moses Kumar, M.D.
-
Haley Sinclair, PA-C
-
Sean Sterner, PA-C
-
Chin-Chin Yeh, MD
-
Ghassan Abuhamad, MD
-
Naveen Balasundaram, M.D.
-
Asad J Choudhry, MBBS
-
Judith W Cook, MD
-
David Lorelli, MD
-
Kwaku Opoku, MD
-
Tariq Rahman, MD
-
Farda Qayyum, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040709000543 | PA | Part B Supplier - Clinic/Group Practice | 2264336460 |
Receives reassigned benefits from 30 practitioners Practice locations: Williamsport, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | |||
| Vascular Surgery Physician |
2086S0129X | Yes |
Addresses
Primary practice location
740 High St
Suite 3001
Williamsport, PA 17701-3102
Mailing address
1201 Grampian Blvd
Williamsport, PA 17701-1900
Other names
- Susquehanna Health Medical Group
Other providers in Williamsport, PA
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Physician Services
- Susquehanna Urologic Associates LTD
All providers in Williamsport, PA · Vascular Surgery Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.