Healthcare Provider Details

I. General information

NPI: 1538694377
Provider Name (Legal Business Name): JODY ERNEST SARNO C.PED. CFO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 WHITTIER ST
VANDERGRIFT PA
15690-1660
US

IV. Provider business mailing address

227 WHITTIER ST
VANDERGRIFT PA
15690-1660
US

V. Phone/Fax

Practice location:
  • Phone: 724-594-7718
  • Fax:
Mailing address:
  • Phone: 724-594-7718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: