Provider Demographics
NPI: | 1790944759 |
---|---|
Name: | PERINATAL CARDIOLOGY CONSULTANTS |
Entity Type: | Organization |
Organization Name: | PERINATAL CARDIOLOGY CONSULTANTS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DOCTOR/OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | SHARON |
Authorized Official - Middle Name: | ROBYN |
Authorized Official - Last Name: | WEIL-CHALKER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 610-789-0643 |
Mailing Address - Street 1: | 127 W CHESTER PIKE |
Mailing Address - Street 2: | |
Mailing Address - City: | HAVERTOWN |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19083-5315 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 610-789-0643 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 127 W CHESTER PIKE |
Practice Address - Street 2: | |
Practice Address - City: | HAVERTOWN |
Practice Address - State: | PA |
Practice Address - Zip Code: | 19083-5315 |
Practice Address - Country: | US |
Practice Address - Phone: | 610-789-0643 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-06-05 |
Last Update Date: | 2008-06-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | MD037618E | 174400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 174400000X | Other Service Providers | Specialist | Group - Single Specialty |