Provider Demographics
NPI:1245262245
Name:LANKEN, PAUL N (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:N
Last Name:LANKEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3400 SPRUCE STREET
Mailing Address - Street 2:843 WEST GATES
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:843 WEST GATES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-3202
Practice Address - Fax:215-614-0914
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD017154E207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006626410002Medicaid
PA042424Medicare ID - Type Unspecified
PA0006626410002Medicaid