Provider Demographics
NPI:1699817353
Name:PILANIA, PRAMOD (MD)
Entity Type:Individual
Prefix:
First Name:PRAMOD
Middle Name:
Last Name:PILANIA
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:PO BOX 5519
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-0519
Mailing Address - Country:US
Mailing Address - Phone:484-221-9135
Mailing Address - Fax:484-221-9130
Practice Address - Street 1:2927 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-2800
Practice Address - Country:US
Practice Address - Phone:215-291-4957
Practice Address - Fax:484-221-9130
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4275062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101550339Medicaid
PAI50750OtherCBH
PAI50750Medicare UPIN
PAI50750OtherCBH