Provider Demographics
NPI:1033558671
Name:LANKENAU MEDICAL CENTER
Entity Type:Organization
Organization Name:LANKENAU MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GOPI
Authorized Official - Middle Name:
Authorized Official - Last Name:UKANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-680-2900
Mailing Address - Street 1:4700 CITY AVE
Mailing Address - Street 2:APT 4803
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1500
Mailing Address - Country:US
Mailing Address - Phone:412-680-2900
Mailing Address - Fax:
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:MOB S SUITE 422
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:484-476-2169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT205197282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital