Provider Demographics
NPI:1306834189
Name:GANAS, CHRISTIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:L
Last Name:GANAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4885 DEMOSS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4885 DEMOSS RD STE 101
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-9024
Practice Address - Country:US
Practice Address - Phone:610-898-7070
Practice Address - Fax:610-779-3923
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065716L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA18220890003Medicaid
PA026331Medicare PIN
PAG91052Medicare UPIN