OrganizationActive
Surya K. Vangore M.D. P.C
NPI 1750565263 · Health Maintenance Organization · Philadelphia, PA
Provider details
- NPI number
- 1750565263
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Parent organization
- Surya K. Vangore M.D.
- Authorized official
- Surya Vangore, Primary Care Physcian
- License
- MD038910L (PA)
Practice location
431 W Roosevelt Blvd
Philadelphia, PA 19120-4148
Phone: (215) 455-3444
Fax: (215) 455-3445
Mailing address
431 W Roosevelt Blvd
Philadelphia, PA 19120-4148
Registry dates
- Enumerated
- 2007-12-19
- Last updated
- 2020-03-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.