SERRIE C LICO (NPI# 1790746790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790746790 |
| Entity Type | Individual |
| Full Name | SERRIE C LICO |
| Credential | MD |
| Practice Address |
875 Poplar Church Rd Suite 400 Camp Hill PA 17011-2203 |
| Mailing Address |
205 Grandview Ave Suite 210 Camp Hill PA 17011-1708 |
| Practice Telephone | 7179750900 |
| Practice Fax Number | 7179752724 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 25MA10202300 | NJ | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD068831L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03112934 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 65 W Jimmie Leeds Rd Ste 1, Pomona, NJ 082409102 | 6097487089 | 6096523460 |
| Street Address |
875 POPLAR CHURCH RD SUITE 400 |
| City | CAMP HILL |
| State | PA |
| Zip Code | 17011-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295738441 | Lenke Erki | Internal Medicine | 875 Poplar Church Rd, Suite 400, Camp Hill, PA 17011-2203 | 2005-05-23 |
| 1649770918 | Rachael Marie Rock | Physician Assistant | 875 Poplar Church Rd, Camp Hill, PA 17011-2203 | 2018-02-13 |
| 1669986428 | Satvir Kaur Gill | Physical Therapist | 875 Poplar Church Rd, Camp Hill, PA 17011-2203 | 2017-11-30 |
| 1720527203 | Brittany Luzik | Physical Therapist | 875 Poplar Church Rd, Camp Hill, PA 17011-2203 | 2017-02-17 |
| 1649713165 | Christine Nicole Hoover | Physical Therapist | 875 Poplar Church Rd, Camp Hill, PA 17011-2203 | 2016-12-01 |
| 1528511623 | Michelle Tewell | Audiologist | 875 Poplar Church Rd, Suite 320, Camp Hill, PA 17011-2203 | 2016-07-26 |
| 1528433794 | Jaclyn Scott | Nurse Practitioner | 875 Poplar Church Rd, Camp Hill, PA 17011-2203 | 2015-12-14 |
| 1851778666 | Holy Spirit Hospital | Clinic/Center | 875 Poplar Church Rd, Camp Hill, PA 17011-2203 | 2015-04-30 |
| 1295010916 | Julie Lauren Graver | Physician Assistant | 875 Poplar Church Rd, Suite 400, Camp Hill, PA 17011-2203 | 2011-10-13 |
| 1598048704 | Jamie Michele Roberts | Physician Assistant | 875 Poplar Church Rd, Suite 320, Camp Hill, PA 17011-2203 | 2011-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790241628 | Harrisburg Home Care | Home Health | 1713 Hammel Road, R2, Harrisburg, PA 17011 | 2019-02-15 |
| 1427540269 | Eldercare Solutions LLC | Adult Companion | 1926 Market Street, Camp Hill, PA 17011 | 2018-06-06 |
| 1538680244 | Edward Joseph Hilton | Dentist | 3412 Trindle Road, Camp Hill, PA 17011 | 2017-07-03 |
| 1639609696 | Alicia Taylor Brustein | Physician Assistant | 425 North 21st Street, Suite 405, Camp Hill, PA 17011 | 2017-06-13 |
| 1285166843 | Betsy Earnest, Lpc, LLC | Counselor | 1509 Cedar Cliff Drive, Suite 4, Camp Hill, PA 17011 | 2017-03-31 |
| 1962852368 | Angela Antonia Debo | Family Medicine | 3025 Market Street, Entrance B, Camp Hill, PA 17011 | 2016-06-16 |
| 1033567839 | Timothy Zack Day | Physician Assistant | 897 Poplar Rd, Camp Hill, PA 17011 | 2016-06-02 |
| 1962864892 | Tracy Byra | Registered Nurse | 15 Scarsdale Drive, Camp Hill, PA 17011 | 2016-03-21 |
| 1245634138 | Charlotte Diane Hain | Psychologist | 781 Poplar Church Road, Camp Hill, PA 17011 | 2014-10-21 |
| 1205276805 | Isaac S Chiang | Optometrist | South 32nd Street & Trindle Rd, Camp Hill, PA 17011 | 2013-06-27 |
| Find all providers in zip 17011 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215196886 | William Bowman Iams | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1721 Olmsted Way W, Camp Hill, PA 17011-8460 | 2008-06-08 |
| 1215255864 | Spirit Physician Services, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 875 Poplar Church Rd, Suite 400, Camp Hill, PA 17011-2203 | 2010-05-06 |
| 1619926482 | Capital Area Cardiovascular Surgical Institute | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 423 N 21st St, Suite 301, Camp Hill, PA 17011-2207 | 2006-05-09 |
| 1154389559 | John Leslie Pennock | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 423 N 21st St, Suite 300, Camp Hill, PA 17011-2207 | 2006-05-03 |
| 1346243292 | John Mathai | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 875 Poplar Church Rd, Suite 310, Camp Hill, PA 17011-2203 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639707847 | West Virginia Univesity Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1163 Country Club Rd Ste 106, Monongahela, PA 15063-1013 | 2020-04-01 |
| 1861959884 | Pedro Augusto Reck Dos Santos | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 Lothrop St # C900, Pittsburgh, PA 15213-2536 | 2019-02-26 |
| 1023582418 | Luciana Da Fonseca Da Silva | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4401 Penn Ave Fl 5, Pittsburgh, PA 15224-1334 | 2019-01-18 |
| 1962980730 | Wellspan Medical Group | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 40 V Twin Dr Ste 102, Gettysburg, PA 17325-7878 | 2018-08-02 |
| 1295110427 | Chananya Karunasumetta | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4101 Penn Avenue, 5th Fl. Faculty Pavilion, Pittsburgh, PA 15224 | 2015-07-29 |
| 1528443041 | Michael Ibrahim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3701 Chestnut St Apt 410, Philadelphia, PA 19104-3104 | 2015-07-27 |
| 1710386420 | Ferdinand Christian | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1224 Turnbury Ln, North Wales, PA 19454-3657 | 2014-08-19 |
| 1245668128 | Jacob Kolff | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1125 Bryn Llawn Road, Villanova, PA 19085 | 2013-10-31 |
| 1144665399 | William Schuler Pierce | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1201 Saradana Road, Harrisburg, PA 17112 | 2013-05-01 |
| 1215279112 | Jeffrey M Dunn | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 W. Washington Sq, #1207, Philadelphia, PA 19106 | 2013-03-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.