Provider Demographics
NPI:1902662943
Name:TILL, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:TILL
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 1:926 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREEN LANE
Mailing Address - State:PA
Mailing Address - Zip Code:18054-2029
Mailing Address - Country:US
Mailing Address - Phone:267-903-4505
Mailing Address - Fax:
Practice Address - Street 1:926 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:GREEN LANE
Practice Address - State:PA
Practice Address - Zip Code:18054-2029
Practice Address - Country:US
Practice Address - Phone:267-903-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife