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Individual

ILANA R BALTUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3400 SPRUCE STREET, GROUND SILVERSTEIN BLDG, PHILADELPHIA, PA 19104-4283
(215) 662-6698
(215) 662-3953
Mailing address
3400 SPRUCE STREET, GROUND RAVDIN, PHILADELPHIA, PA 19104-4283
(215) 662-6698
(215) 662-3953

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD456580
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0694223
NJ
Enumeration date
04/30/2013
Last updated
11/07/2025
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