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General NPI Number Information
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NPI Number | 1497297972
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Entity Type | Organization
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Legal Business Name | SYDANDI LLC
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 2824 COTTMAN AVE SUITE 7
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1400
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Country | US
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Telephone | 215-273-6704
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Fax | 215-904-5073
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Provider Business Mailing Address
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Address Line | 257 N 2ND ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1320
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CMO/GM
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Name | WANDA TINDALL
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Credential |
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Telephone | 215-273-6704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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