Provider Demographics
NPI:1124409826
Name:KALRA, SANJOG (MD)
Entity Type:Individual
Prefix:MR
First Name:SANJOG
Middle Name:
Last Name:KALRA
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 1:5501 OLD YORK ROAD, 3RD FLOOR LEVY BUILDING
Mailing Address - Street 2:ALBERT EINSTEIN MEDICAL CENTER-DIVISION OF CARDIOLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141
Mailing Address - Country:US
Mailing Address - Phone:215-456-3930
Mailing Address - Fax:212-342-3660
Practice Address - Street 1:5501 OLD YORK ROAD, 3RD FLOOR LEVY BUILDING
Practice Address - Street 2:ALBERT EINSTEIN MEDICAL CENTER-DIVISION OF CARDIOLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141
Practice Address - Country:US
Practice Address - Phone:215-456-3930
Practice Address - Fax:212-342-3660
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2017-01-06
Deactivation Date:2016-01-25
Deactivation Code:
Reactivation Date:2016-12-20
Provider Licenses
StateLicense IDTaxonomies
PAMD459443207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology