Provider Demographics
NPI:1386682888
Name:PUNJABI, PRIYA H (MD)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:H
Last Name:PUNJABI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRIYA
Other - Middle Name:
Other - Last Name:PUNJABI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1629 BRIDGETOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4218
Mailing Address - Country:US
Mailing Address - Phone:215-322-6987
Mailing Address - Fax:215-322-4553
Practice Address - Street 1:2250 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-3831
Practice Address - Country:US
Practice Address - Phone:215-427-3343
Practice Address - Fax:215-427-0533
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038932L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00839635-02Medicaid
PA00839635-02Medicaid
PA842271Medicare ID - Type Unspecified