SUSANNA PANTELYAT MD NPI 1679669899

NPI Information

NPI: 1679669899
Provider Name: SUSANNA PANTELYAT, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
2112 WELSH RD
PHILADELPHIA, PA
ZIP 19115
Phone: (215) 673-1498
Get Directions

Susanna Pantelyat, MD is a neurology psychiatry neurology in Philadelphia, PA with 42 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Susanna Pantelyat, MD NPI is 1679669899. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2112 WELSH RD
PHILADELPHIA, PA
ZIP 19115
Phone: (215) 673-1498
Fax: (215) 673-4299

The NPI 1679669899 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 9/22/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	25MA07382000	NEW JERSEY	No
2	2084N0400X	Psychiatry & Neurology	Neurology	MD417337	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A3226157	OTHER	PENNSYLVANIA	AETNA
2	071250	MEDICARE ID-TYPE UNSPECIFIED	PENNSYLVANIA
3	001871360	MEDICAID	PENNSYLVANIA
4	30009182	OTHER	PENNSYLVANIA	KEYSTONE MERCY
5	H54022	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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