Healthcare Provider Details

I. General information

NPI: 1669247730
Provider Name (Legal Business Name): SARAH B KAEWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 LAFAYETTE DR
JAMISON PA
18929-1642
US

IV. Provider business mailing address

1727 LAFAYETTE DR
JAMISON PA
18929-1642
US

V. Phone/Fax

Practice location:
  • Phone: 267-337-4447
  • Fax:
Mailing address:
  • Phone: 267-337-4447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI005578
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: