Healthcare Provider Details

I. General information

NPI: 1811677990
Provider Name (Legal Business Name): SABRINA BECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 VETERANS AVE
BATH NY
14810-0840
US

IV. Provider business mailing address

107 MILKY WAY
SHIPPENSBURG PA
17257-8241
US

V. Phone/Fax

Practice location:
  • Phone: 607-664-4000
  • Fax:
Mailing address:
  • Phone: 717-360-4987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW138320
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: