Basic Information
| Provider Information | |||||||||
| NPI: | 1538891627 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SKRENES | ||||||||
| FirstName: | SANJAR | ||||||||
| MiddleName: | NEJATIAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7916 ARDLEIGH ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191184402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565105363 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8835 GERMANTOWN AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191182718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154821234 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2022 | ||||||||
| LastUpdateDate: | 06/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MT227344 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.