Provider Demographics
NPI:1093710592
Name:PALANT, MARINA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:
Last Name:PALANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1323
Mailing Address - Country:US
Mailing Address - Phone:610-525-2719
Mailing Address - Fax:
Practice Address - Street 1:875 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3113
Practice Address - Country:US
Practice Address - Phone:610-527-0310
Practice Address - Fax:610-527-1275
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029335E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist