Healthcare Provider Details

I. General information

NPI: 1922007079
Provider Name (Legal Business Name): RENEE ANN SANGRIGOLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 W STATE ST STE 200
DOYLESTOWN PA
18901-2567
US

IV. Provider business mailing address

PO BOX 829641
PHILADELPHIA PA
19182-9641
US

V. Phone/Fax

Practice location:
  • Phone: 267-893-6800
  • Fax: 267-893-6820
Mailing address:
  • Phone: 672-370-5296
  • Fax: 215-230-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD056938L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberMD056938L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0018394240001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: