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General NPI Number Information
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NPI Number | 1134662364
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Entity Type | Individual
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Provider Name | BRADIE SARAH POLLLARD MS, LAT, ATC,CSCS
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Gender | Female
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Dates
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Enumeration Date | 11/20/2016
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 85 TAYLOR RD
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City | WHARTON
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State | NJ
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Zip | 07885
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Country | US
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Telephone | 973-713-6495
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Fax |
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Provider Business Mailing Address
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Address Line | 85 TAYLOR RD
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City | WHARTON
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State | NJ
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Zip | 07885-1501
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Country | US
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Telephone | 973-713-6495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT.5689
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT007913
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License Number State | PA
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