Provider Demographics
NPI:1609919679
Name:SAILAJA MUSUNURI, MD, LLC
Entity Type:Organization
Organization Name:SAILAJA MUSUNURI, MD, LLC
Other - Org Name:CHESTER COUNTY CHILD AND ADOLESCENT PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAILAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSUNURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-280-9888
Mailing Address - Street 1:91 DOWLIN FORGE ROAD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341
Mailing Address - Country:US
Mailing Address - Phone:610-280-9888
Mailing Address - Fax:610-280-9788
Practice Address - Street 1:91 DOWLIN FORGE ROAD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341
Practice Address - Country:US
Practice Address - Phone:610-280-9888
Practice Address - Fax:610-280-9788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center