Provider Demographics
NPI:1669433587
Name:YANOFSKY, CHARLES S (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:S
Last Name:YANOFSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:550 N 12TH ST
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043
Practice Address - Country:US
Practice Address - Phone:717-975-8585
Practice Address - Fax:717-975-0670
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDMD026483E2084N0400X
PAMD024683E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA818028OtherFIRST PRIORITY HEALTH
PA0014789680007Medicaid
PA135232OtherHIGHMARK BLUE SHIELD
PA15453OtherGEISINGER HEALTH PLAN
PA1553560OtherUNITEDHEALTHCARE
PA5644043OtherAETNA
PAB38124OtherHEALTHAMERICA
PAP00459448OtherRAILROAD MEDICARE
PA50054353OtherCAPITAL BLUE CROSS
PAP00459448OtherRAILROAD MEDICARE
PAB38124Medicare UPIN