Healthcare Provider Details

I. General information

NPI: 1295390763
Provider Name (Legal Business Name): SARA SADEGHI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 E WATERFRONT DR STE 230
HOMESTEAD PA
15120-1151
US

IV. Provider business mailing address

495 E WATERFRONT DR STE 230
HOMESTEAD PA
15120-1151
US

V. Phone/Fax

Practice location:
  • Phone: 412-461-1108
  • Fax: 412-461-5490
Mailing address:
  • Phone: 412-461-1108
  • Fax: 412-461-5490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC007253
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007253
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: