Provider Demographics
NPI:1902661861
Name:SYAL, AMIT
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:SYAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 S CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1615
Mailing Address - Country:US
Mailing Address - Phone:623-640-3030
Mailing Address - Fax:
Practice Address - Street 1:419 S CARLISLE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1615
Practice Address - Country:US
Practice Address - Phone:623-640-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program