Provider Demographics
NPI:1851950745
Name:SANDILOS, GEORGIANNA AMELIA (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGIANNA
Middle Name:AMELIA
Last Name:SANDILOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 PINE ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6101
Mailing Address - Country:US
Mailing Address - Phone:267-432-1178
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ RM 411
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:267-432-1178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program