Provider Demographics
NPI:1801331046
Name:PANCIR, DARCY LYNN (NP)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:LYNN
Last Name:PANCIR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 WALNUT ST
Mailing Address - Street 2:APT. 305
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4587
Mailing Address - Country:US
Mailing Address - Phone:631-807-9312
Mailing Address - Fax:
Practice Address - Street 1:2600 N AMERICAN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-3413
Practice Address - Country:US
Practice Address - Phone:215-739-2669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-26
Last Update Date:2016-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016942363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health