Provider Demographics
NPI:1700800489
Name:KANANI, PRAPTI MULRAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAPTI
Middle Name:MULRAJ
Last Name:KANANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3500 BROOKTREE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9277
Mailing Address - Country:US
Mailing Address - Phone:724-940-0220
Mailing Address - Fax:724-940-0221
Practice Address - Street 1:3500 BROOKTREE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9277
Practice Address - Country:US
Practice Address - Phone:724-940-0220
Practice Address - Fax:724-940-0221
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-067599-L2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG15527Medicare UPIN
PA028409EBOMedicare ID - Type Unspecified