Provider Demographics
NPI:1598920290
Name:UNDAVIA, SATYEN (MD)
Entity Type:Individual
Prefix:
First Name:SATYEN
Middle Name:
Last Name:UNDAVIA
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 1:173 SERENITY CT
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1905
Mailing Address - Country:US
Mailing Address - Phone:610-446-6900
Mailing Address - Fax:
Practice Address - Street 1:301 W CHESTER PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-4530
Practice Address - Country:US
Practice Address - Phone:610-446-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451679174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist