1306979489 NPI number — DR. RAVI K SAPRA MD

Table of content: DR. RAVI K SAPRA MD (NPI 1306979489)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306979489 NPI number — DR. RAVI K SAPRA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAPRA
Provider First Name:
RAVI
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306979489
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
826 JUNIPER DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE HILL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-296-3770
Provider Business Mailing Address Fax Number:
215-487-4563

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ROXBOROUGH MEMORIAL HOSPITAL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-483-9900
Provider Business Practice Location Address Fax Number:
215-487-4563
Provider Enumeration Date:
03/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  MD032333L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084N0400X , with the licence number: 037902 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)