Provider Demographics
NPI:1932849197
Name:DAN LANTSMAN, CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:DAN LANTSMAN
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 1:200 NORTH WYNNEWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 SOUTH 10TH STREET
Practice Address - Street 2:SUITE 1099J
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5244
Practice Address - Country:US
Practice Address - Phone:215-955-6028
Practice Address - Fax:215-955-1102
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-12-29
Deactivation Date:2022-12-27
Deactivation Code:
Reactivation Date:2022-12-29
Provider Licenses
StateLicense IDTaxonomies
PAMT2247912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology