| Doctor Name: | MS. CARLA A. PIANKA |
| NPI Number: | 1972693661 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MP00018 |
| Business Practice Address: | 15000 Midlantic Dr Suite 102 Mt. Laurel, NJ - 08054 |
| Business Phone Number: | 8562555479 |
| Business Fax Number: | 8563938372 |
| Mailing Address: | 15000 Midlantic Dr, Suite 102 MT. LAUREL |
| State: | NJ |
| Postal Code: | 08054 |
| Phone Number: | 8562555479 |
| Fax Number: | 8563938372 |
| NPI Enumeration Date: | 10/13/2006 |
| NPI Last Update Date: | 03/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | MP00018 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |