Provider Demographics
NPI:1417122177
Name:LANCASTER GALS PC
Entity Type:Organization
Organization Name:LANCASTER GALS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZAFARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYVANI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-669-2164
Mailing Address - Street 1:6 N PENRYN RD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-9326
Mailing Address - Country:US
Mailing Address - Phone:717-665-4963
Mailing Address - Fax:717-627-0821
Practice Address - Street 1:6 N PENRYN RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-9326
Practice Address - Country:US
Practice Address - Phone:717-665-4963
Practice Address - Fax:717-627-0821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010743L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019099770003Medicaid
PAH69994Medicare UPIN