Basic Information
Provider Information
NPI: 1235215427
EntityType: 2
ReplacementNPI:  
OrganizationName: GEISINGER MEDICAL CENTER
LastName:  
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Credential:  
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Mailing Information
Address1: 5 LAKEVIEW DR
Address2:  
City: MOOSIC
State: PA
PostalCode: 18705
CountryCode: US
TelephoneNumber: 5702715555
FaxNumber:  
Practice Location
Address1: 100 N ACADEMY AVE
Address2:  
City: DANVILLE
State: PA
PostalCode: 17822
CountryCode: US
TelephoneNumber: 5702716211
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/31/2006
LastUpdateDate: 02/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: MULL
AuthorizedOfficialFirstName: CINDY
AuthorizedOfficialMiddleName: L
AuthorizedOfficialTitleorPosition: SYSTEM DIRECTOR
AuthorizedOfficialTelephone: 5702716603
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 02/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261Q00000X071801PAN Ambulatory Health Care FacilitiesClinic/Center 
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


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