MEDICARE: JANINE VAN LANCKER M.D.

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	207R00000X	Internal Medicine Physician	D0062976	MD
2	207K00000X	Allergy & Immunology Physician	MD036731	DC

General Provider Information

NPI Number	:	1275524985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANINE VAN LANCKER M.D.

Provider Business Mailing Address
First Line	:	2801 QUEBEC ST. N.W.
Second Line	:	#422N
City	:	WASHINGTON
State	:	DC
Zip	:	20008
Country	:	US
Telephone Number	:	312-399-8678
Fax Number	:	301-470-3757

Provider Business Practice Location Address
First Line	:	2150 PENNSYLVANIA AVE NW
Second Line	:	SUITE G-402
City	:	WASHINGTON
State	:	DC
Zip	:	20037-3201
Country	:	US
Telephone Number	:	202-741-2771
Fax Number	:	202-741-2775

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/31/2007

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Directions to “ JANINE VAN LANCKER M.D.” Practice Location

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