Provider Demographics
NPI:1104806371
Name:DANZIK, PATRICIA ANN (MSS)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:DANZIK
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PINE TREE RD
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3709
Mailing Address - Country:US
Mailing Address - Phone:610-964-8028
Mailing Address - Fax:610-964-0779
Practice Address - Street 1:201 PINE TREE RD
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-3709
Practice Address - Country:US
Practice Address - Phone:610-964-8028
Practice Address - Fax:610-964-0779
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW000713L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADA640355OtherHIGHMARK BLUS SHIELD
PA4541448OtherAETNA BEHAVIORAL HLTH.
PA118470OtherMHN
PA118470OtherMHN