Basic Information
| Provider Information | |||||||||
| NPI: | 1124409826 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KALRA | ||||||||
| FirstName: | SANJOG | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5501 OLD YORK ROAD, 3RD FLOOR LEVY BUILDING | ||||||||
| Address2: | ALBERT EINSTEIN MEDICAL CENTER-DIVISION OF CARDIOLOGY | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154563930 | ||||||||
| FaxNumber: | 2123423660 | ||||||||
| Practice Location | |||||||||
| Address1: | 5501 OLD YORK ROAD, 3RD FLOOR LEVY BUILDING | ||||||||
| Address2: | ALBERT EINSTEIN MEDICAL CENTER-DIVISION OF CARDIOLOGY | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154563930 | ||||||||
| FaxNumber: | 2123423660 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2015 | ||||||||
| LastUpdateDate: | 01/06/2017 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 01/25/2016 | ||||||||
| NPIReactivationDate: | 12/20/2016 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | MD459443 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.