Provider Demographics
NPI:1063485076
Name:LAVANGA, DANIEL FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:FRANK
Last Name:LAVANGA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E PENNSYLVANIA BLVD
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7843
Mailing Address - Country:US
Mailing Address - Phone:215-364-1112
Mailing Address - Fax:215-364-3231
Practice Address - Street 1:112 E PENNSYLVANIA BLVD
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:19053-7843
Practice Address - Country:US
Practice Address - Phone:215-364-1112
Practice Address - Fax:215-364-3231
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003377L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1390763OtherHIGHMARK BLUESHIELD
PA2080174000OtherPERSONAL CHOICE KEYSTONE
5017555OtherAETNA
LA488763OtherPREMIER BLUESHIELD
11500832OtherCAQH
2823869OtherAETNA
4924929OtherCIGNA
663095OtherACN GROUP
PA0061159000OtherPERSONAL CHOICE KEYSTONE
381023OtherMAMSI
740993OtherFIRST HEALTH
N90763OtherAMERIHEALTH/AMI
1038026OtherASHN
3685273OtherAETNA
663095OtherACN GROUP
740993OtherFIRST HEALTH