Provider Demographics
NPI:1750994422
Name:VANJONACK, DELORES A (MSS, RDCS, RCS, RVS)
Entity type:Individual
Prefix:
First Name:DELORES
Middle Name:A
Last Name:VANJONACK
Suffix:
Gender:F
Credentials:MSS, RDCS, RCS, RVS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2094 FLOWING SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-2632
Mailing Address - Country:US
Mailing Address - Phone:215-939-0668
Mailing Address - Fax:732-993-7700
Practice Address - Street 1:2094 FLOWING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-2632
Practice Address - Country:US
Practice Address - Phone:215-939-0668
Practice Address - Fax:732-993-7700
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA700152085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound