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General NPI Number Information
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NPI Number | 1154405264
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Entity Type | Individual
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Provider Name | PRAVIN A TANEJA M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN ERIE AVE AT FRONT STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19134-1095
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Country | US
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Telephone | 215-427-5220
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Fax | 215-427-4339
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Provider Business Mailing Address
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Address Line | PO BOX 13579
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City | READING
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State | PA
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Zip | 19612-3579
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Country | US
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Telephone | 484-628-1324
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD427498
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | MD427498
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License Number State | PA
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