Provider Demographics
NPI:1912404450
Name:PAUL, REEMA PALANKAR (DO)
Entity Type:Individual
Prefix:
First Name:REEMA
Middle Name:PALANKAR
Last Name:PAUL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:REEMA
Other - Middle Name:MACHENDRANATH
Other - Last Name:PALANKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:160 E ERIE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-1011
Mailing Address - Country:US
Mailing Address - Phone:215-427-5151
Mailing Address - Fax:215-427-6910
Practice Address - Street 1:160 E ERIE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-1011
Practice Address - Country:US
Practice Address - Phone:215-427-5151
Practice Address - Fax:215-427-6910
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT020509390200000X
TXV08342080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine