Provider Demographics
NPI:1871580308
Name:DANSKY, LARRY S (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:S
Last Name:DANSKY
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 1:7133 NITTANY VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-9013
Mailing Address - Country:US
Mailing Address - Phone:570-726-7992
Mailing Address - Fax:570-726-6554
Practice Address - Street 1:7133 NITTANY VALLEY DR
Practice Address - Street 2:
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-9013
Practice Address - Country:US
Practice Address - Phone:570-726-7992
Practice Address - Fax:570-726-6554
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046407L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012283100001Medicaid
PA052881Medicare PIN
A75192Medicare UPIN