Provider Demographics
NPI:1184702649
Name:PALATHINGAL, CELINA G (MD)
Entity type:Individual
Prefix:DR
First Name:CELINA
Middle Name:G
Last Name:PALATHINGAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CELINA
Other - Middle Name:G
Other - Last Name:PALATHINGAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4 VANESSA CT
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2948
Mailing Address - Country:US
Mailing Address - Phone:856-489-0461
Mailing Address - Fax:
Practice Address - Street 1:301 SPRING GARDEN RD
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2516
Practice Address - Country:US
Practice Address - Phone:609-561-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ63273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ066466C2BOtherMEDICARE BILLING NO.
NJ066466C2BOtherMEDICARE BILLING NO.
NJH77334Medicare ID - Type UnspecifiedPHYSICIAN IDENTIFICATION