Healthcare Provider Details

I. General information

NPI: 1053844373
Provider Name (Legal Business Name): SARA KASS-GERGI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WALNUT ST FL SQUARE9
PHILADELPHIA PA
19107-5176
US

IV. Provider business mailing address

3400 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-5127
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-5027
  • Fax: 215-829-6391
Mailing address:
  • Phone: 215-300-1831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD474896
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD474896
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD474896
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: