MEDICARE: SARAH BIENENFELD

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
1	225X00000X	Occupational Therapist	46TR00663400	NJ

General Provider Information

NPI Number	:	1992107460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH BIENENFELD

Provider Business Mailing Address
First Line	:	3502 SCOTTS LN
Second Line	:	SUITE 711
City	:	PHILADELPHIA
State	:	PA
Zip	:	19129-1561
Country	:	US
Telephone Number	:	917-753-0984
Fax Number	:

Provider Business Practice Location Address
First Line	:	3502 SCOTTS LN
Second Line	:	SUITE 711
City	:	PHILADELPHIA
State	:	PA
Zip	:	19129-1561
Country	:	US
Telephone Number	:	917-753-0984
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	12/05/2016

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