Healthcare Provider Details

I. General information

NPI: 1609800929
Provider Name (Legal Business Name): RANDA D. SIFRI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CHESTNUT ST SUITE 301
PHILADELPHIA PA
19107-4414
US

IV. Provider business mailing address

833 CHESTNUT ST SUITE 301
PHILADELPHIA PA
19107-4414
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-7190
  • Fax: 215-923-9186
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License NumberMD045284L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD045284L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD045284L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: