Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | R93418 | NY |
N | 222Z00000X | Podiatrist | R93418 | NY |
Y | 213E00000X | Podiatrist | SC006885 | PA |
Y | 222Z00000X | Podiatrist | SC006885 | PA |
N | 213EP1101X | Primary Podiatric Medicine | SC006885 | PA |
NPI | 1164837324 |
---|---|
Provider Name | Dr. Sarah Dougherty |
First Address | Canonsburg, PA 15317-4977 |
Second Address | Washington, PA 15301-5864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 17/03/2018 |