Basic Information
| Provider Information | |||||||||
| NPI: | 1447278478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUMASIA | ||||||||
| FirstName: | RUPAL | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 217 HARRISBURG AVE | ||||||||
| Address2: | THE HEART GROUP OF LGHEALTH | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176032962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175448300 | ||||||||
| FaxNumber: | 7175448265 | ||||||||
| Practice Location | |||||||||
| Address1: | 217 HARRISBURG AVE | ||||||||
| Address2: | THE HEART GROUP OF LGHEALTH | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176032962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175448300 | ||||||||
| FaxNumber: | 7175448265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 01/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MD430266 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | MD430266 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 1018218340001 | 05 | PA | MEDICAID |