Provider Demographics
NPI:1225420482
Name:SAING, SOTHEA PETER (NP-C)
Entity type:Individual
Prefix:MR
First Name:SOTHEA
Middle Name:PETER
Last Name:SAING
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 HARRISBURG PIKE STE 202
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-869-4600
Mailing Address - Fax:717-544-3501
Practice Address - Street 1:2112 HARRISBURG PIKE STE 202
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-869-4600
Practice Address - Fax:717-544-3501
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19176363LF0000X
PASP018152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1034843400002Medicaid
PASP018152OtherCRNP LICENSE
PA1034843400001Medicaid
PA635617KKUOtherMEDICARE