Basic Information
Provider Information
NPI: 1073220661
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLENDERS
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 214 READING CIR
Address2:  
City: LANSDALE
State: PA
PostalCode: 194463964
CountryCode: US
TelephoneNumber: 6107727665
FaxNumber:  
Practice Location
Address1: 3401 CIVIC CENTER BLVD
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191044319
CountryCode: US
TelephoneNumber: 2155901000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/02/2022
LastUpdateDate: 11/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207PP0204XMA063947PAY Allopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine

No ID Information.


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