Healthcare Provider Details

I. General information

NPI: 1831334176
Provider Name (Legal Business Name): AMRITA KOCHHAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 LOMBARD STREET
PHILADELPHIA PA
19146-1498
US

IV. Provider business mailing address

1840 SOUTH STREET TUTTLEMAN BUILDING
PHILADELPHIA PA
19146-7411
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-7817
  • Fax:
Mailing address:
  • Phone: 215-893-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD437240
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: