Basic Information
| Provider Information | |||||||||
| NPI: | 1538120324 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOLANIN-SAIFI | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | V | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4400 CARLISLE PIKE | ||||||||
| Address2: | |||||||||
| City: | CAMP HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170114132 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4400 CARLISLE PIKE | ||||||||
| Address2: | |||||||||
| City: | CAMP HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170114132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179759800 | ||||||||
| FaxNumber: | 7179755509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 12/08/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD071528L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 80174963 | 01 | PA | RAILROAD MEDICARE | OTHER | 813563 | 01 | PA | BLUE CROSS | OTHER | 001848218 0001 | 05 | PA | MEDICAID | 000813563 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER |