Basic Information
| Provider Information | |||||||||
| NPI: | 1114927365 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANCIANO | ||||||||
| FirstName: | RACHELLE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020A E BOAL AVE | ||||||||
| Address2: | |||||||||
| City: | BOALSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 168271509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8142378627 | ||||||||
| FaxNumber: | 8142380083 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 N LANSDOWNE AVE | ||||||||
| Address2: | |||||||||
| City: | DREXEL HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190261114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102848240 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2005 | ||||||||
| LastUpdateDate: | 01/05/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | MD034807E | PA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 0011451290004 | 05 | PA | MEDICAID | 0000124213604 | 01 | PA | UNITED HEALTHCARE | OTHER | 711705 | 01 | PA | CIGNA | OTHER | 0055583 | 01 | PA | AETNA USHC | OTHER | 0092209000 | 01 | PA | KEYSTONE HEALTH PLAN EAST | OTHER | 201041 | 01 | PA | PA BCBS | OTHER | 0114512901 | 01 | PA | AMERICHOICE | OTHER |