Provider Demographics
NPI:1548023823
Name:ENGST, GINA (LAC DIPL)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:ENGST
Suffix:
Gender:F
Credentials:LAC DIPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2414
Mailing Address - Country:US
Mailing Address - Phone:215-847-4533
Mailing Address - Fax:
Practice Address - Street 1:345 E MOUNT AIRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1114
Practice Address - Country:US
Practice Address - Phone:215-847-4533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001327171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist