Provider Demographics
NPI:1982801874
Name:PENTA, PRADEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:PRADEEP
Middle Name:
Last Name:PENTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:317 E 34TH ST FL 9
Mailing Address - Street 2:MURRAY HILL MEDICAL GROUP
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4974
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:317 E 34TH ST FL 9
Practice Address - Street 2:MURRAY HILL MEDICAL GROUP
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4974
Practice Address - Country:US
Practice Address - Phone:212-726-7400
Practice Address - Fax:212-981-7220
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2012-02-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2567222081P2900X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine