Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD046647L | PA |
N | 111NI0900X | Internist | MD046647L | PA |
N | 207RC0000X | Internist - Cardiovascular Disease | MD046647L | PA |
Y | 207RI0011X | Interventional Cardiology | MD046647L | PA |
NPI | 1124054812 |
---|---|
Provider Name | Daniel M Kolansky |
First Address | Philadelphia, PA 19104-5127 |
Second Address | Philadelphia, PA 19104-5127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 16/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0013981970002 | (05) | PA |
E39972 | (02) |