Healthcare Provider Details

I. General information

NPI: 1710568274
Provider Name (Legal Business Name): SARAH JEAN ZEDAR PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N MAIN AVE
SCRANTON PA
18504-3304
US

IV. Provider business mailing address

2096 BETHANY TPKE
PLEASANT MOUNT PA
18453-4508
US

V. Phone/Fax

Practice location:
  • Phone: 570-904-4142
  • Fax: 570-507-9270
Mailing address:
  • Phone: 570-862-3865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number022827
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: