Basic Information
Provider Information
NPI: 1669834669
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAHHAM
FirstName: SARI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1020 SANSOM ST STE 239
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191075002
CountryCode: US
TelephoneNumber: 2159556844
FaxNumber: 2159552526
Practice Location
Address1: 1020 SANSOM ST STE 239
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191075002
CountryCode: US
TelephoneNumber: 2159556844
FaxNumber: 2159552526
Other Information
ProviderEnumerationDate: 03/28/2016
LastUpdateDate: 12/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD466742PAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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