Individual
JUSTIN JOSEPH PANTHAPPATTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-8000
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA11886500
NJ
207RN0300X
Nephrology Physician
Primary
MT232269
PA
Other
Enumeration date
03/29/2020
Last updated
07/17/2025
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