Healthcare Provider Details

I. General information

NPI: 1659561009
Provider Name (Legal Business Name): CHRISTINE DANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 01/16/2021
Certification Date: 01/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 HIGHLANDS DR
LITITZ PA
17543-7694
US

IV. Provider business mailing address

1500 HIGHLANDS DR
LITITZ PA
17543-7694
US

V. Phone/Fax

Practice location:
  • Phone: 717-988-0000
  • Fax:
Mailing address:
  • Phone: 717-988-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD432467
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1021735410002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier0178471
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: