Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | OT017361 | PA |
NPI | 1033561881 |
---|---|
Provider Name | Sara English |
First Address | Meadville, PA 16335-2559 |
Second Address | Meadville, PA 16335-2559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2016 |
Last Update Date | 05/07/2016 |