Basic Information
| Provider Information | |||||||||
| NPI: | 1932848082 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BILGER | ||||||||
| FirstName: | SHAELYNN | ||||||||
| MiddleName: | MACENZIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 711 N 4TH ST APT A | ||||||||
| Address2: | |||||||||
| City: | SUNBURY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178011213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702386277 | ||||||||
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| Practice Location | |||||||||
| Address1: | 45 US-11 | ||||||||
| Address2: | |||||||||
| City: | SHAMOKIN DAM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5709313849 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2022 | ||||||||
| LastUpdateDate: | 05/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | PA | Y |
No ID Information.