Provider Demographics
NPI:1609122951
Name:BANCOFF, ALIZA (CD(DONA))
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:BANCOFF
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 MERION PL
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1515
Mailing Address - Country:US
Mailing Address - Phone:484-802-6100
Mailing Address - Fax:
Practice Address - Street 1:409 MERION PL
Practice Address - Street 2:
Practice Address - City:MERION STATION
Practice Address - State:PA
Practice Address - Zip Code:19066-1515
Practice Address - Country:US
Practice Address - Phone:484-802-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula