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General NPI Number Information
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NPI Number | 1992930408
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Entity Type | Individual
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Provider Name | SARA DANA WASSERMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 3737 MARKET ST FL 6
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 215-662-2454
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Fax | 215-662-7527
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Provider Business Mailing Address
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Address Line | 3737 MARKET ST FL 6
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City | PHILADELPHIA
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State | PA
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Zip | 19104-5545
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Country | US
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Telephone | 215-662-2454
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Fax | 215-662-7527
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD459659
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License Number State | PA
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