Active NPI
Sondra L Corgan, MD
- Child & Adolescent Psychiatry Physician
- Bala Cynwyd, PA
National Provider Identifier
1184087132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD468549
- Practice address
- 333 E City Ave Ste PL13
Bala Cynwyd, PA 19004-1506 - Phone
- (267) 225-1745
- Fax
- (973) 440-3267
- NPI assigned
- Mar 29, 2016
- Last updated
- Dec 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MT219443 | PA | |
| Psychiatry Physician | 2084P0800X | MD468549 | PA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD468549 | PA | Primary |
Addresses
Primary practice location
333 E City Ave Ste PL13
Bala Cynwyd, PA 19004-1506
Mailing address
333 E City Ave Ste PL13
Bala Cynwyd, PA 19004-1506
Phone (267) 224-1745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD468549 | PA | MD | Child & Adolescent Psychiatry Physician |
| MT219443 | PA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670112000000",
"number": "1184087132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 E CITY AVE STE PL13",
"city": "BALA CYNWYD",
"state": "PA",
"postal_code": "190041506",
"telephone_number": "267-224-1745",
"fax_number": "973-440-3267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 E CITY AVE STE PL13",
"city": "BALA CYNWYD",
"state": "PA",
"postal_code": "190041506",
"telephone_number": "267-225-1745",
"fax_number": "973-440-3267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORGAN",
"first_name": "SONDRA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-29",
"last_updated": "2022-12-04",
"certification_date": "2022-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "MT219443",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD468549",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "PA",
"license": "MD468549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bala Cynwyd, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.