SUSQUEHANNA PHYSICIAN SERVICES NPI 1619996733

NPI Information

NPI: 1619996733
Provider Name: SUSQUEHANNA PHYSICIAN SERVICES
Classification: Plastic Surgery - 208200000X
Entity Type: Organization
Other Name: SPS-PLASTIC SURGERY
Address: 1201 GRAMPIAN BLVD
SUITE 1B
WILLIAMSPORT, PA
ZIP 17701
Phone: (570) 320-7570

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NPI Details

SUSQUEHANNA PHYSICIAN SERVICES is a plastic surgery in Williamsport, PA. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. SUSQUEHANNA PHYSICIAN SERVICES NPI is 1619996733. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Sps-plastic Surgery.

The provider's business location address is:

1201 GRAMPIAN BLVD
SUITE 1B
WILLIAMSPORT, PA
ZIP 17701-900
Phone: (570) 320-7570
Fax: (570) 320-7571

The provider's authorized official is Charles Santangelo .
The authorized official title is Executive Vp/cfo and has the following contact phone number (570) 321-3171.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 10/18/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0122X	Surgery	Plastic and Reconstructive Surgery			No
2	208200000X	Plastic Surgery				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	221536	OTHER	PENNSYLVANIA	FIRST PRIORITY HEALTH
2	1743458	OTHER	PENNSYLVANIA	HIGHMARK BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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