Provider Demographics
NPI:1285748418
Name:SAPANARA, NANCY L (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:SAPANARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W ELM ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2007
Mailing Address - Country:US
Mailing Address - Phone:610-567-6964
Mailing Address - Fax:610-567-6170
Practice Address - Street 1:1500 LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1200
Practice Address - Country:US
Practice Address - Phone:610-237-4185
Practice Address - Fax:610-237-4017
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425182207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30036369OtherKMHP
PA2757685000OtherKEYSTONE HEALTH PLAN EAST
PA1892680OtherBLUE SHIELD
PA1017189040001Medicaid
PA105607HNBMedicare PIN
PAP00421185Medicare PIN