Organization
CGC MANAGEMENT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER GERARD CIANCI DC (OWNER)
(215) 631-1595
Entity
Organization
Contact information
Practice address
611 S BROAD ST, LANSDALE, PA 19446-3702
(215) 631-1595
(215) 631-1596
Mailing address
611 S BROAD ST, LANSDALE, PA 19446-3702
(215) 631-1595
(215) 631-1596
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC005306-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1432995
PA BS GROUP NUMBER
PA
01
—
2119560000
KEYSTONE HMO GRP ID
PA
Enumeration date
02/05/2007
Last updated
08/22/2020
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