Provider Demographics
NPI: | 1194771725 |
---|---|
Name: | BARBARA M. SARACINO D.O.,PC |
Entity type: | Organization |
Organization Name: | BARBARA M. SARACINO D.O.,PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/PHYSICIAN |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | BARBARA |
Authorized Official - Middle Name: | MARY |
Authorized Official - Last Name: | SARACINO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 215-968-5814 |
Mailing Address - Street 1: | 4 TERRY DR |
Mailing Address - Street 2: | SUITE#11 |
Mailing Address - City: | NEWTOWN |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18940-1838 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 215-968-5814 |
Mailing Address - Fax: | 215-968-9389 |
Practice Address - Street 1: | 4 TERRY DR |
Practice Address - Street 2: | SUITE#11 |
Practice Address - City: | NEWTOWN |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18940-1838 |
Practice Address - Country: | US |
Practice Address - Phone: | 215-968-5814 |
Practice Address - Fax: | 215-968-9389 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-25 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | OS-006515-L | 261Q00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |