Basic Information
| Provider Information | |||||||||
| NPI: | 1831452051 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KADAKIA | ||||||||
| FirstName: | SAGAR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1015 WALNUT ST STE 620 | ||||||||
| Address2: | SUITE 1003 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191075005 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 WALNUT ST FL 5 | ||||||||
| Address2: | SUITE 1003 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159556750 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2012 | ||||||||
| LastUpdateDate: | 05/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD461953 | PA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.