Basic Information
Provider Information
NPI: 1124162730
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAKLA
FirstName: AMIR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 RIVER RD
Address2: STE 100
City: CONSHOHOCKEN
State: PA
PostalCode: 194282439
CountryCode: US
TelephoneNumber: 8003553818
FaxNumber: 6108342862
Practice Location
Address1: 110 IRVING ST NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200102976
CountryCode: US
TelephoneNumber: 2028779696
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/16/2007
LastUpdateDate: 11/27/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD20741DCY Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XD0037159MDN Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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