Healthcare Provider Details

I. General information

NPI: 1508865304
Provider Name (Legal Business Name): CHRISTINE S STANKO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 05/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 E LANCASTER AVE STE 200
VILLANOVA PA
19085
US

IV. Provider business mailing address

775 E LANCASTER AVE STE 200
VILLANOVA PA
19085-1529
US

V. Phone/Fax

Practice location:
  • Phone: 610-525-7800
  • Fax: 610-525-7801
Mailing address:
  • Phone: 610-525-7800
  • Fax: 610-525-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberMD421785
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: