Individual
DR. HAL BRADLEY GANZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12401 ACADEMY RD, SUITE 203, PHILADELPHIA, PA 19154-1932
(215) 637-3100
Mailing address
12401 ACADEMY RD, SUITE 203, PHILADELPHIA, PA 19154-1932
(215) 637-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS007829-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01667778
—
PA
Enumeration date
12/09/2006
Last updated
07/08/2007
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