Individual
GREGORY BANCROFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4014 LANCASTER AVE, A, PHILADELPHIA, PA 19104-1712
(215) 222-2225
(215) 222-3070
Mailing address
4014 LANCASTER AVE, A, PHILADELPHIA, PA 19104-1712
(215) 222-2225
(215) 222-3070
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC-001795-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005005270002
—
PA
Enumeration date
07/03/2006
Last updated
07/17/2015
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