Basic Information
| Provider Information | |||||||||
| NPI: | 1134728850 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MERULLI | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BECKER | ||||||||
| OtherFirstName: | SARAH | ||||||||
| OtherMiddleName: | ELIZABETH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | SEWICKLEY VALLEY PEDIATRIC AND ADOLESCENT MEDICINE, PC | ||||||||
| Address2: | 701 BROAD STREET, SUITE 422 | ||||||||
| City: | SEWICKLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151431652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127418700 | ||||||||
| FaxNumber: | 4127423710 | ||||||||
| Practice Location | |||||||||
| Address1: | SEWICKLEY VALLEY PEDIATRIC AND ADOLESCENT MEDICINE, PC | ||||||||
| Address2: | 701 BROAD ST, SUITE 422 | ||||||||
| City: | SEWICKLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151431652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127418700 | ||||||||
| FaxNumber: | 4127413710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2020 | ||||||||
| LastUpdateDate: | 10/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 10/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | SP022283 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.