Basic Information
| Provider Information | |||||||||
| NPI: | 1619940541 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATOR | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | MARY | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 555 N. DUKE ST. | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175445511 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 555 N DUKE ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176022250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175445511 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2006 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZB0001X | MD041243E | PA | N | Allopathic & Osteopathic Physicians | Pathology | Blood Banking & Transfusion Medicine | 207ZP0102X | MD041243E | PA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 30001345 | 01 | PA | KEYSTONE MERCY | OTHER | 50056048 | 01 | PA | KEYSTONE HEALTH PLAN CENTRAL | OTHER | 1002513 | 01 | PA | AMERIHEALTH MERCY | OTHER | 7359436 | 01 | PA | AETNA - NON HMO | OTHER | 000616162 | 01 | PA | HIGHMARK | OTHER | 001678350 0001 | 05 | PA | MEDICAID | 220021406 | 01 | PA | MEDICARE - RAILROAD | OTHER | 000000126581 | 01 | PA | UNISON | OTHER | 0444471000 | 01 | PA | INDEPENDENCE BLUE CROSS | OTHER | 1150091 | 01 | PA | AETNA - HMO | OTHER | 1538629 | 01 | PA | GATEWAY | OTHER | 50056048 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 53080 | 01 | PA | GEISINGER HEALTH PLAN | OTHER |