MEDICARE: DR. JANETTE GOBRAN GHATTAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD048334L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	801331	OTHER	PA	BS
2	01167702	OTHER		BC

General Provider Information

NPI Number	:	1134215296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANETTE GOBRAN GHATTAS MD

Provider Business Mailing Address
First Line	:	120 PROSPECT STREET
Second Line	:
City	:	READING
State	:	PA
Zip	:	19606-2871
Country	:	US
Telephone Number	:	610-777-3330
Fax Number	:	610-779-1844

Provider Business Practice Location Address
First Line	:	120 PROSPECT STREET
Second Line	:
City	:	READING
State	:	PA
Zip	:	19606-2871
Country	:	US
Telephone Number	:	610-777-3330
Fax Number	:	610-779-1844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/21/2022

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