Provider Demographics
NPI:1346539418
Name:PATHMANATHAN, ISHANI (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ISHANI
Middle Name:
Last Name:PATHMANATHAN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10913 ORLEANS WAY
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1113
Mailing Address - Country:US
Mailing Address - Phone:301-661-1175
Mailing Address - Fax:
Practice Address - Street 1:1430 TULANE AVE # SL-50
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-7809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program