Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD061307L | PA |
NPI | 1225083405 |
---|---|
Provider Name | Dr. Leonard Ira Ganz |
First Address | Beaver, PA 15009-1919 |
Second Address | Beaver, PA 15009-1919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 16/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0016498780013 | (05) | PA |
F98166 | (02) | PA |