Provider Demographics
NPI:1013970391
Name:PANDE, REENA LAWANDE (MD)
Entity Type:Individual
Prefix:
First Name:REENA
Middle Name:LAWANDE
Last Name:PANDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REENA
Other - Middle Name:RATNAKAR
Other - Last Name:LAWANDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:86 GRIGGS RD
Mailing Address - Street 2:APT. 23
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4764
Mailing Address - Country:US
Mailing Address - Phone:617-738-0754
Mailing Address - Fax:617-738-0754
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-7139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210823 (LIMITED)207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine