Healthcare Provider Details

I. General information

NPI: 1447255831
Provider Name (Legal Business Name): JOCELYN J SIVALINGAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 09/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 CHESTNUT ST STE 1518
PHILADELPHIA PA
19107-4315
US

IV. Provider business mailing address

1015 CHESTNUT ST STE 1518
PHILADELPHIA PA
19107-4315
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-1060
  • Fax: 215-955-9502
Mailing address:
  • Phone: 215-955-1060
  • Fax: 215-955-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD042484E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: