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General NPI Number Information
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NPI Number | 1669667069
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Entity Type | Organization
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Legal Business Name | P SABANAYAGAM MD PC
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Dates
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Enumeration Date | 09/09/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 8201 ARMENT DR
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City | GLEN MILLS
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State | PA
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Zip | 19342-2302
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Country | US
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Telephone | 610-622-9670
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Fax | 610-459-1035
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Provider Business Mailing Address
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Address Line | 441 W 21ST ST
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City | CHESTER
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State | PA
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Zip | 19013-4919
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Country | US
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Telephone | 610-622-9670
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. P SABANAYAGAM
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Credential | MD
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Telephone | 610-622-9670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD014776E
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License Number State | PA
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