Provider Demographics
NPI:1770734378
Name:BAJAJ, PUNEET (MD)
Entity type:Individual
Prefix:DR
First Name:PUNEET
Middle Name:
Last Name:BAJAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:190 WELLES ST STE 122
Practice Address - Street 2:
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704-4961
Practice Address - Country:US
Practice Address - Phone:570-718-4140
Practice Address - Fax:570-718-4141
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195719390200000X
PAMD4480892080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program