Provider Demographics
NPI:1083837371
Name:SAGREIYA, USHA (MD)
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:
Last Name:SAGREIYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E MOUNT AIRY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1713
Mailing Address - Country:US
Mailing Address - Phone:215-248-6700
Mailing Address - Fax:
Practice Address - Street 1:5429 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-2223
Practice Address - Country:US
Practice Address - Phone:215-843-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057968L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000172M0XMedicare PIN
PA000172FG8Medicare PIN
PAG57076Medicare UPIN