Healthcare Provider Details

I. General information

NPI: 1316393994
Provider Name (Legal Business Name): SARAH E. THORNTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 08/03/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 WALNUT ST STE 930
PHILADELPHIA PA
19107-5109
US

IV. Provider business mailing address

840 WALNUT ST STE 1230
PHILADELPHIA PA
19107-5109
US

V. Phone/Fax

Practice location:
  • Phone: 215-928-3130
  • Fax: 215-592-1923
Mailing address:
  • Phone: 215-440-3160
  • Fax: 215-928-3465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License NumberMD470397
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD470397
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: