Provider Demographics
NPI:1396146585
Name:JORDAN, SARAH E
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:JORDAN
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 1:440 E 23RD ST
Mailing Address - Street 2:APT 1G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5002
Mailing Address - Country:US
Mailing Address - Phone:212-974-7252
Mailing Address - Fax:212-974-7228
Practice Address - Street 1:250 W 54TH ST STE 805
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5558
Practice Address - Country:US
Practice Address - Phone:917-727-1527
Practice Address - Fax:212-202-3652
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038089208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation