Individual
PAMELA VANTASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 N. NARBERTH AVENUE, NARBERTH, PA 19072-1807
(610) 667-7855
(866) 898-2159
Mailing address
23625 COMMERCE PARK, STE. 204, BEACHWOOD, OH 44122
(216) 255-5700
(216) 255-5701
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
MD071655L
PA
2085R0202X
Diagnostic Radiology Physician
10807
SC
2085R0202X
Diagnostic Radiology Physician
G7364
TX
2085R0202X
Diagnostic Radiology Physician
Primary
MD071655L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108074
—
SC
05
—
1851324982
—
IA
05
—
1851324982
—
MI
05
—
2916705
—
OH
05
—
64601206
—
KY
05
—
8533119
—
WA
01
—
P00898180
RXR MEDICARE
PA
Enumeration date
07/09/2006
Last updated
11/23/2011
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