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NPI 1508859091

NPI 1508859091 : VINIT PANDE M.D. : WILKES BARRE, PA

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General NPI Number Information
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    NPI Number           |    1508859091
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    Entity Type          |    Individual 
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    Provider Name        |    VINIT PANDE M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/30/2005
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    Last Update Date     |    02/23/2015
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Provider Practice Location Address
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    Address Line         |    150 MUNDY ST 
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    City                 |    WILKES BARRE
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    State                |    PA
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    Zip                  |    18702-6830
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    Country              |    US
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    Telephone            |    570-824-0930
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    Fax                  |    570-824-7755
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Provider Business Mailing Address
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    Address Line         |    150 MUNDY ST 
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    City                 |    WILKES BARRE
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    State                |    PA
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    Zip                  |    18702-6830
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    Country              |    US
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    Telephone            |    570-824-0930
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    Fax                  |    570-824-7755
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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        |    2081P2900X
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    Taxonomy Name        |    Pain Medicine (Physical Medicine & Rehabilitation) Physician
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    License Number       |    MD417162
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    208100000X
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    Taxonomy Name        |    Physical Medicine & Rehabilitation Physician
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    License Number       |    MD417162
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    License Number State |    PA
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