Provider Demographics
NPI:1982439725
Name:TOMASULO, SARA (MT-BC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TOMASULO
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N FIVE POINTS RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4777
Mailing Address - Country:US
Mailing Address - Phone:610-444-7030
Mailing Address - Fax:
Practice Address - Street 1:44 SOMERSET DR
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:PA
Practice Address - Zip Code:19362-9703
Practice Address - Country:US
Practice Address - Phone:484-667-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA15980225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist