Provider Demographics
NPI:1316809726
Name:ELLWOOD, SARA FLORENCE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:FLORENCE
Last Name:ELLWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 GIBNER RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-5086
Mailing Address - Country:US
Mailing Address - Phone:571-821-7659
Mailing Address - Fax:571-821-7652
Practice Address - Street 1:450 GIBNER RD STE 1
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-5086
Practice Address - Country:US
Practice Address - Phone:571-821-7659
Practice Address - Fax:571-821-7652
Is Sole Proprietor?:No
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other