Provider Demographics
NPI:1588664015
Name:JANA, DILIP K (MD)
Entity Type:Individual
Prefix:
First Name:DILIP
Middle Name:K
Last Name:JANA
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 1:2931 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1842
Mailing Address - Country:US
Mailing Address - Phone:814-456-6258
Mailing Address - Fax:814-456-6258
Practice Address - Street 1:2931 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1842
Practice Address - Country:US
Practice Address - Phone:814-456-6258
Practice Address - Fax:814-456-6258
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018905E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D71457Medicare UPIN