Provider Demographics
NPI:1538101936
Name:TOTLANI, RAJENDER S (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJENDER
Middle Name:S
Last Name:TOTLANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N 17TH ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5034
Mailing Address - Country:US
Mailing Address - Phone:610-434-2162
Mailing Address - Fax:610-434-9370
Practice Address - Street 1:401 N 17TH ST
Practice Address - Street 2:SUITE 307
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5034
Practice Address - Country:US
Practice Address - Phone:610-434-2162
Practice Address - Fax:610-434-9370
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA059331LL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1233001OtherCAPITAL BLUE CROSS
PA16057840008Medicaid
7425084OtherAETNA PPO POS
PA892891OtherHIGHMARK BLUE SHIELD
2310516OtherAETNA HMO
P001506OtherGATEWAY
1233001OtherCAPITAL BLUE CROSS
P001506OtherGATEWAY