Healthcare Provider Details

I. General information

NPI: 1083344741
Provider Name (Legal Business Name): PRISCILLA ESADAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 MARKET ST 9TH FLOOR
PHILADELPHIA PA
19104-5548
US

IV. Provider business mailing address

3737 MARKET ST 9TH FLOOR
PHILADELPHIA PA
19104-1014
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-8777
  • Fax: 215-243-4601
Mailing address:
  • Phone: 215-662-8777
  • Fax: 215-243-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD488450
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: