Healthcare Provider Details

I. General information

NPI: 1922387331
Provider Name (Legal Business Name): ORANEE SANMANEECHAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH & CIVIC CENTER BOULEVARD CHOP-DEPARTMENT OF NEUROLOGY
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

34TH & CIVIC CENTER BOULEVARD CHOP-DEPARTMENT OF NEUROLOGY
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1710
  • Fax: 215-590-2950
Mailing address:
  • Phone: 215-590-1710
  • Fax: 215-590-2950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberMD443123
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: