Healthcare Provider Details

I. General information

NPI: 1497068837
Provider Name (Legal Business Name): ARCHANA SATYAL CHAUDHARY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 CENTRAL AVE 2ND FLOOR FOUNDERS BUILDING
PHILADELPHIA PA
19111-2442
US

IV. Provider business mailing address

2450 W HUNTING PARK AVE @ND FLOOR TPI
PHILADELPHIA PA
19129-1302
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-2276
  • Fax: 215-214-4119
Mailing address:
  • Phone: 215-926-9022
  • Fax: 215-226-8286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD449244
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD449244
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: