Healthcare Provider Details

I. General information

NPI: 1619382819
Provider Name (Legal Business Name): DHANYA NARAYANA PANICKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 LANARK RD
CENTER VALLEY PA
18034-8694
US

IV. Provider business mailing address

5445 LANARK RD STE 300
CENTER VALLEY PA
18034-8694
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-7300
  • Fax: 866-449-5832
Mailing address:
  • Phone: 484-526-7300
  • Fax: 866-449-5832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA148733
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberMT233245
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: