Provider Demographics
NPI:1629480371
Name:STANLEY, ALISON (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:STANLEY
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 1:700 LANCASTER ROAD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-2314
Mailing Address - Country:US
Mailing Address - Phone:717-665-2496
Mailing Address - Fax:717-665-6345
Practice Address - Street 1:700 LANCASTER RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-2314
Practice Address - Country:US
Practice Address - Phone:717-665-2496
Practice Address - Fax:717-665-6345
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD460905207Q00000X
PAMT205975390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program