Basic Information
| Provider Information | |||||||||
| NPI: | 1265442412 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GANSNER | ||||||||
| FirstName: | ROBYN | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1623 MORGANTOWN RD | ||||||||
| Address2: | |||||||||
| City: | READING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107966354 | ||||||||
| FaxNumber: | 6107966470 | ||||||||
| Practice Location | |||||||||
| Address1: | 1623 MORGANTOWN RD | ||||||||
| Address2: | |||||||||
| City: | READING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6107966354 | ||||||||
| FaxNumber: | 6107966470 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 208100000X | MD 037583 E | PA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 0376001 | 01 | CAPITAL BLUE CROSS | OTHER | 1162836 | 05 | PA | MEDICAID | 178864 | 01 | BLUE SHIELD | OTHER |