Provider Demographics
NPI:1932193190
Name:SUGAR, RONIT Z (MD)
Entity Type:Individual
Prefix:
First Name:RONIT
Middle Name:Z
Last Name:SUGAR
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:PO BOX 8500-8735
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-254-2599
Practice Address - Street 1:1330 POWELL ST STE 603
Practice Address - Street 2:SUITE 603
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3358
Practice Address - Country:US
Practice Address - Phone:610-272-8452
Practice Address - Fax:610-272-8459
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030554E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011234530006Medicaid
PA0011234530006Medicaid
PAB42356Medicare UPIN