Provider Demographics
NPI:1386697001
Name:CODORI, GREGORY J (DO)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:CODORI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-337-4249
Practice Address - Street 1:147 GETTYS ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2534
Practice Address - Country:US
Practice Address - Phone:717-337-4216
Practice Address - Fax:717-337-4249
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS008086L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1521174OtherGATEWAY
PA412782OtherHIGHMARK BLUE SHIELD
PA413903OtherUPMC
PA001483743Medicaid
PA144650OtherUNITED HEALTHCARE COMM PLAN
PA20016168OtherAMERIHEALTH MERCY
PA50067124OtherCAPITAL BLUE CROSS
PA412782GVQMedicare PIN
PA20016168OtherAMERIHEALTH MERCY
PA144650OtherUNITED HEALTHCARE COMM PLAN