Provider Demographics
NPI:1396707774
Name:HANLEY, TERRANCE P (MD)
Entity type:Individual
Prefix:
First Name:TERRANCE
Middle Name:P
Last Name:HANLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S 7TH AVE
Mailing Address - Street 2:SUITE 3070
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1410
Mailing Address - Country:US
Mailing Address - Phone:610-375-4381
Mailing Address - Fax:610-375-3770
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:SUITE 3070
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:610-375-4381
Practice Address - Fax:610-375-3770
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057267L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016352640006Medicaid
PA01171501OtherCAPITAL BLUE CROSS
PA895174OtherHIGHMARK BLUE SHIELD
PA01171501OtherCAPITAL BLUE CROSS
PAG45465Medicare UPIN