Individual
DR. NICHOLAS LOUIS PANETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E LANCASTER AVE STE 230, WYNNEWOOD, PA 19096-3451
(610) 642-3796
(610) 642-2943
Mailing address
100 E LANCASTER AVE STE 230, WYNNEWOOD, PA 19096-3451
(610) 642-3796
(610) 642-2943
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD432897
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD432897
PA
207RP1001X
Pulmonary Disease Physician
Primary
MD432897
PA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD432897
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007278000
MEDICAID TPI GROUP
PA
01
—
597586
MEDICARE TPI GROUP
PA
01
—
CD4829
RAILROAD MEDICARE TPI GROUP
PA
Enumeration date
07/11/2008
Last updated
12/01/2014
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