Provider Demographics
NPI:1700213055
Name:GHELANI, SUJAL P (DO)
Entity Type:Individual
Prefix:DR
First Name:SUJAL
Middle Name:P
Last Name:GHELANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 EXTON CMNS
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2450
Mailing Address - Country:US
Mailing Address - Phone:484-897-7143
Mailing Address - Fax:
Practice Address - Street 1:310 EXTON CMNS
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2450
Practice Address - Country:US
Practice Address - Phone:484-897-7143
Practice Address - Fax:484-328-6491
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018675207RA0201X, 2080P0201X, 207K00000X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology