Provider Demographics
NPI:1992824320
Name:PATHEJA, JOTINDER KAUR (MD)
Entity Type:Individual
Prefix:
First Name:JOTINDER
Middle Name:KAUR
Last Name:PATHEJA
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 1:2787 WALKER CT
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-9307
Mailing Address - Country:US
Mailing Address - Phone:724-327-8647
Mailing Address - Fax:724-327-8647
Practice Address - Street 1:2787 WALKER CT
Practice Address - Street 2:
Practice Address - City:EXPORT
Practice Address - State:PA
Practice Address - Zip Code:15632-9307
Practice Address - Country:US
Practice Address - Phone:724-327-8647
Practice Address - Fax:724-327-8647
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038641L2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD038641LOtherMEDICAL LICENSE