Provider Demographics
NPI:1639625809
Name:SLOBOGIN, GINA (CRNP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:SLOBOGIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CHERRY TREE RD
Mailing Address - Street 2:
Mailing Address - City:UPPER CHICHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19014-2406
Mailing Address - Country:US
Mailing Address - Phone:610-485-6700
Mailing Address - Fax:
Practice Address - Street 1:400 CHERRY TREE RD
Practice Address - Street 2:
Practice Address - City:UPPER CHICHESTER
Practice Address - State:PA
Practice Address - Zip Code:19014-2406
Practice Address - Country:US
Practice Address - Phone:610-485-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016510207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine