Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | P30075 | MD |
Y | 2080N0001X | Neonatal-Perinatal Doctor | OS020662 | PA |
NPI | 1104230788 |
---|---|
Provider Name | Dr. Sarah M Mahdally |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2014 |
Last Update Date | 17/07/2020 |