Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 40QA01494700 | NJ |
NPI | 1073808572 |
---|---|
Provider Name | Mrs. Sarah Elizabeth Tagliavia |
First Address | Plymouth Meeting, PA 19462-1420 |
Second Address | Cherry Hill, NJ 08034-1414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 12/11/2015 |