Healthcare Provider Details

I. General information

NPI: 1982925467
Provider Name (Legal Business Name): ZARA YEGANEH MERGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S BRYN MAWR AVE
BRYN MAWR PA
19010-3121
US

IV. Provider business mailing address

610 W GERMANTOWN PIKE STE 150
PLYMOUTH MEETING PA
19462-1062
US

V. Phone/Fax

Practice location:
  • Phone: 610-526-3000
  • Fax:
Mailing address:
  • Phone: 610-525-4966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD452624
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: