Provider Demographics
NPI:1316901820
Name:TWO RIVERS FAMILY HEALTHCARE, P.C.
Entity type:Organization
Organization Name:TWO RIVERS FAMILY HEALTHCARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CORNELIUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-834-3900
Mailing Address - Street 1:4 S MARKET ST
Mailing Address - Street 2:FIRST FLOOR RIGHT REAR
Mailing Address - City:DUNCANNON
Mailing Address - State:PA
Mailing Address - Zip Code:17020-1225
Mailing Address - Country:US
Mailing Address - Phone:717-834-3900
Mailing Address - Fax:
Practice Address - Street 1:4 S MARKET ST
Practice Address - Street 2:FIRST FLOOR RIGHT REAR
Practice Address - City:DUNCANNON
Practice Address - State:PA
Practice Address - Zip Code:17020-1225
Practice Address - Country:US
Practice Address - Phone:717-834-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA092505Medicare ID - Type Unspecified