Provider Demographics
NPI:1700824877
Name:AMARAL, SANDRA GOMES (MD, MHS)
Entity Type:Individual
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First Name:SANDRA
Middle Name:GOMES
Last Name:AMARAL
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Gender:F
Credentials:MD, MHS
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Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9234
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA - NEPHROLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-2449
Practice Address - Fax:215-590-0425
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2018-11-29
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Provider Licenses
StateLicense IDTaxonomies
PAMD4438262080P0210X
WI44038-0202080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026348180001Medicaid