=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801862057
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANAND MAHAJAN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2006
-----------------------------------------------------
Last Update Date | 06/10/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 690 GOOD DR CHCA NEONATOLOGY @ LANCASTER GENERAL
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17601-2433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-544-3700
-----------------------------------------------------
Fax | 717-544-3371
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 E PENN SQ FL 9 CHCA NEONATOLOGY
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19107-3377
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-425-9232
-----------------------------------------------------
Fax | 267-425-9299
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080N0001X
-----------------------------------------------------
Taxonomy Name | Neonatal-Perinatal Medicine Physician
-----------------------------------------------------
License Number | MD039699L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------