Provider Demographics
NPI:1285820415
Name:SANJAY PALEKAR MD INC
Entity type:Organization
Organization Name:SANJAY PALEKAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PALEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-322-0780
Mailing Address - Street 1:436 E RIVER ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5200
Mailing Address - Country:US
Mailing Address - Phone:440-322-0780
Mailing Address - Fax:440-322-9094
Practice Address - Street 1:436 E RIVER ST
Practice Address - Street 2:SUITE 8
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5200
Practice Address - Country:US
Practice Address - Phone:440-322-0780
Practice Address - Fax:440-322-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046073174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3010851Medicaid
OH1279640001Medicare NSC
OH3010851Medicaid