Basic Information
Provider Information
NPI: 1417162017
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAVEIGA
FirstName: SIGRID
MiddleName: PAYNE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 E PENN SQ
Address2: 9TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191073323
CountryCode: US
TelephoneNumber: 2674259234
FaxNumber: 2674259299
Practice Location
Address1: 3550 MARKET ST FL 3
Address2: CHILDREN'S HOSPITAL OF PHILADELPHIA - ALLERGY & IMMUN
City: PHILADELPHIA
State: PA
PostalCode: 191043365
CountryCode: US
TelephoneNumber: 2155902549
FaxNumber: 2155904529
Other Information
ProviderEnumerationDate: 05/14/2007
LastUpdateDate: 04/12/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207KA0200XMD429301PAN Allopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
208000000XMD429301PAN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0201XMD429301PAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology

No ID Information.


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