Provider Demographics
NPI:1235107319
Name:SANSONE, JOANN (DO)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:SANSONE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4227
Mailing Address - Country:US
Mailing Address - Phone:610-239-8970
Mailing Address - Fax:610-239-8978
Practice Address - Street 1:325 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4227
Practice Address - Country:US
Practice Address - Phone:610-239-8970
Practice Address - Fax:610-239-8978
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-005920L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
605564LYYMedicare ID - Type Unspecified
PAE45244Medicare UPIN