Provider Demographics
NPI:1467606558
Name:SHERRY S SHANG LLC
Entity Type:Organization
Organization Name:SHERRY S SHANG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-335-7447
Mailing Address - Street 1:121 N. 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1847
Mailing Address - Country:US
Mailing Address - Phone:215-629-8866
Mailing Address - Fax:215-629-8867
Practice Address - Street 1:384 YORKSHIRE RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1216
Practice Address - Country:US
Practice Address - Phone:412-335-7447
Practice Address - Fax:610-520-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD421264261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology