Provider Demographics
NPI:1497068837
Name:SATYAL CHAUDHARY, ARCHANA
Entity Type:Individual
Prefix:
First Name:ARCHANA
Middle Name:
Last Name:SATYAL CHAUDHARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:@ND FLOOR TPI
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-926-9022
Mailing Address - Fax:215-226-8286
Practice Address - Street 1:7600 CENTRAL AVE
Practice Address - Street 2:2ND FLOOR FOUNDERS BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2442
Practice Address - Country:US
Practice Address - Phone:215-728-2276
Practice Address - Fax:215-214-4119
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD449244207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA342363Medicare PIN