Individual
DR. SIDDHARTH BHATTACHARYYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M,D,
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104
(215) 662-6503
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-6503
Taxonomy
Speciality
Code
Description
License number
State
207SM0001X
Molecular Genetic Pathology (Medical Genetics) Physician
MD456831
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD456831
PA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
MD456831
PA
Other
Enumeration date
07/08/2012
Last updated
10/24/2019
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