Provider Demographics
NPI:1902888696
Name:LANCASTER GASTROENTEROLOGY, INC.
Entity Type:Organization
Organization Name:LANCASTER GASTROENTEROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALLEGRETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-544-3500
Mailing Address - Street 1:2112 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3500
Mailing Address - Fax:717-544-3568
Practice Address - Street 1:2112 HARRISBURG PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3500
Practice Address - Fax:717-544-3568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02332900OtherCAPITAL BLUE CROSS
PA1007685270017Medicaid
PA609589OtherMEDICARE
PA609589OtherHIGHMARK BLUE SHIELD