Basic Information
Provider Information
NPI: 1720606908
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EMBICK
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2494 BERNVILLE RD STE G01
Address2:  
City: READING
State: PA
PostalCode: 196059466
CountryCode: US
TelephoneNumber: 6103782779
FaxNumber: 6103782778
Practice Location
Address1: 2494 BERNVILLE RD STE G01
Address2:  
City: READING
State: PA
PostalCode: 196059466
CountryCode: US
TelephoneNumber: 6103782779
FaxNumber: 6103782778
Other Information
ProviderEnumerationDate: 07/14/2020
LastUpdateDate: 07/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LG0600XSP021829PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology

No ID Information.


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