Basic Information
| Provider Information | |||||||||
| NPI: | 1336142751 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FAN | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 824804 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191824804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025758226 | ||||||||
| FaxNumber: | 3025758342 | ||||||||
| Practice Location | |||||||||
| Address1: | 532 GREENHILL AVE | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198051851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027782229 | ||||||||
| FaxNumber: | 3025045010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2005 | ||||||||
| LastUpdateDate: | 05/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | C1-0005037 | DE | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.