Basic Information
| Provider Information | |||||||||
| NPI: | 1932510302 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAFFRAN | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | L.A.T., PES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8531 VETERANS HWY # 105 | ||||||||
| Address2: | |||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211082651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109872162 | ||||||||
| FaxNumber: | 4109872975 | ||||||||
| Practice Location | |||||||||
| Address1: | 8531 VETERANS HWY # 105 | ||||||||
| Address2: | |||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211082651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109872162 | ||||||||
| FaxNumber: | 4109872975 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2014 | ||||||||
| LastUpdateDate: | 05/19/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | A0000126 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.