Basic Information
| Provider Information | |||||||||
| NPI: | 1144284704 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CEPPA | ||||||||
| FirstName: | FEDERICO | ||||||||
| MiddleName: | ARIEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 304 N WATER ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176033374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172996371 | ||||||||
| FaxNumber: | 7179451587 | ||||||||
| Practice Location | |||||||||
| Address1: | 625 S DUKE ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176024509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172996371 | ||||||||
| FaxNumber: | 7173974948 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 07/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD424433 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 208600000X | MD424433 | PA | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 101584079 | 05 | PA | MEDICAID | 2730086000 | 01 | PA | BCBS | OTHER | 30036899 | 01 | PA | KEYSTONE MERCY | OTHER | 1870557 | 01 | PA | BCBS | OTHER | 7901823 | 01 | PA | AETNA | OTHER | 1248812 | 01 | PA | CIGNA | OTHER |