Individual
PANKAJ JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 NORTH ACADEMY AVE., DANVILLE, PA 17822-2025
(570) 271-6621
(570) 271-6762
Mailing address
100 NORTH ACADEMY AVE., DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
22469
MS
207L00000X
Anesthesiology Physician
Primary
MD457545
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01836067
—
MS
05
—
2406400
—
LA
Enumeration date
09/05/2008
Last updated
09/23/2016
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