Provider Demographics
NPI:1871812875
Name:PENDRAK, INNA (DO)
Entity type:Individual
Prefix:DR
First Name:INNA
Middle Name:
Last Name:PENDRAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TOURNAMENT DR
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-3602
Mailing Address - Country:US
Mailing Address - Phone:215-325-7671
Mailing Address - Fax:
Practice Address - Street 1:100 TOURNAMENT DR
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-3602
Practice Address - Country:US
Practice Address - Phone:215-325-7671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-31
Last Update Date:2010-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007462L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine