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NPI Code Detail

MEDICARE: CHALA SARGENT MD

MEDICARE: CHALA SARGENT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry PhysicianMD042321LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10012140840008OTHERPADPW PROMISE #

General Provider Information

NPI Number : 1437281318
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHALA SARGENT MD
Provider Business Mailing Address
First Line : 109 GORDON LN
Second Line :
City : NORTH WALES
State : PA
Zip : 19454-4277
Country : US
Telephone Number : 267-439-6542
Fax Number : 215-472-7296
Provider Business Practice Location Address
First Line : 111 N 49TH ST
Second Line : FHC FIRST FLOOR
City : PHILADELPHIA
State : PA
Zip : 19139-2718
Country : US
Telephone Number : 215-472-7291
Fax Number : 215-472-7296
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/08/2007

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Directions to “ CHALA SARGENT MD” Practice Location

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