DR. STEPHEN M SANDELICH (NPI# 1114212099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114212099 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN M SANDELICH |
| Credential | MD |
| Practice Address |
3401 N Broad St Philadelphia PA 19140-5103 |
| Mailing Address |
2450 W Hunting Park Ave Philadelphia PA 19129-1302 |
| Practice Telephone | 2157075030 |
| Practice Fax Number | 2157073494 |
| Mailing Telephone | 2157078561 |
| Mailing Fax Number | 2157073677 |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2017-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
C10011479 | DE | Allopathic & Osteopathic Physicians |
| Y | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
MD450594 | PA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MT198952 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
3401 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942205133 | Shefali Agrawal | Specialist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2005-06-15 |
| 1962018523 | Caroline Grace Kelly | Audiologist | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-09-18 |
| 1457965964 | Barbara Ohiaeri | Pharmacist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-09-02 |
| 1710505904 | Cara Greenspan | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-14 | |
| 1013535756 | Srinivasa Prasad Venkata Kanuparthi | Neurological Surgery | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-09 |
| 1417575143 | Sakshi Gandhi | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-09 |
| 1801414594 | Azka Rahman | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-08 |
| 1417574658 | Anna-kaye Marie Brown | Anesthesiology | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-04 |
| 1285251405 | Shalonda Cook | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-03 |
| 1386261501 | Temidayo Aderibigbe | Orthopaedic Surgery | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 207PP0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Pediatric Emergency Medicine |
| Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/ Board certification is provided by the American Board of Emergency Medicine. Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427288745 | Marleny Franco | Emergency Medicine | 34th St and Civic Center Blvd, Ctrb 9121, Children's Hosp of Philadelphia, Div of Emerg Medicine, Philadelphia, PA 19104 | 2009-07-21 |
| 1457523045 | Margaret M Love | Emergency Medicine | Front & Erie Sts, Schc Emergency Dept, Philadelphia, PA 19134 | 2008-03-24 |
| 1790701126 | Abigail Pudpud | Emergency Medicine | 1401 S 31st St Fl 2, Philadelphia, PA 19146-3506 | 2006-07-15 |
| 1174167738 | Meredith Marie Tarbell | Emergency Medicine | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2019-11-06 |
| 1336554641 | Maher Mohammad K. Abulfaraj | Emergency Medicine | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2014-06-25 |
| 1508284365 | Elizabeth Sanseau | Emergency Medicine | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2014-03-30 |
| 1164840989 | Andrea Anderson | Emergency Medicine | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2014-03-29 |
| 1548523855 | Katherine Gupta | Emergency Medicine | 3401 Civic Center Boulevard, Division of Emergency Medicine, Philadelphia, PA 19104 | 2012-06-21 |
| 1235360488 | Beth Simone Etra | Emergency Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2009-08-06 |
| 1699936062 | Luis Ledesma Gamboa | Emergency Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2008-06-18 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.