Healthcare Provider Details

I. General information

NPI: 1275547747
Provider Name (Legal Business Name): HOWARD B PANITCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER BLVD CHILDREN'S HOSPITAL OF PHILADELPHIA -PULMONOLOGY
PHILADELPHIA PA
19104-4319
US

IV. Provider business mailing address

100 E PENN SQ 9TH FLOOR
PHILADELPHIA PA
19107-3323
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-3749
  • Fax: 215-590-3500
Mailing address:
  • Phone: 267-425-9232
  • Fax: 267-425-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberMD029538E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberMD029538E
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number25MA05592200
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number25MA05592200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: