Provider Demographics
NPI:1518050525
Name:JOHNY, SALINI (MD)
Entity Type:Individual
Prefix:
First Name:SALINI
Middle Name:
Last Name:JOHNY
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 1:255 W LANCASTER AVE
Mailing Address - Street 2:FL 1
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1763
Mailing Address - Country:US
Mailing Address - Phone:484-337-4097
Mailing Address - Fax:484-337-4082
Practice Address - Street 1:130 S BRYN MAWR AVE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3121
Practice Address - Country:US
Practice Address - Phone:484-337-4097
Practice Address - Fax:484-337-4082
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429436207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA105580Medicare PIN
PA037276OtherMEDICARE AA #
PA824305OtherB/S AA ACCOUNT
PA232359401OtherMLHC TIN
PA1017346680001Medicaid