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NPI Code Detail

MEDICARE: DR. SARAH EMILY HENRICKSON M.D. PH.D.

MEDICARE: DR. SARAH EMILY HENRICKSON M.D. PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianMT204850PA
22080P0201XPediatric Allergy/Immunology PhysicianMT204850PA

General Provider Information

NPI Number : 1275832826
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH EMILY HENRICKSON M.D. PH.D.
Provider Business Mailing Address
First Line : 3401 CIVIC CENTER BLVD
Second Line : DIVISION OF ALLERGY IMMUNOLOGY
City : PHILADELPHIA
State : PA
Zip : 19104-4319
Country : US
Telephone Number : 215-590-2549
Fax Number : 215-590-4259
Provider Business Practice Location Address
First Line : 3401 CIVIC CENTER BLVD
Second Line : 3550 MARKET STREET, 3RD FLOOR
City : PHILADELPHIA
State : PA
Zip : 19104-4319
Country : US
Telephone Number : 215-590-2549
Fax Number : 215-590-4259
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2011
Last Update Date : 04/12/2023

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