Basic Information
Provider Information
NPI: 1396810511
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURKART
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 636256
Address2: CENTRAL CREDENTIALING
City: CINCINNATI
State: OH
PostalCode: 452636256
CountryCode: US
TelephoneNumber: 5135855505
FaxNumber: 5135855511
Practice Location
Address1: 231 ALBERT SABIN WAY
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452670001
CountryCode: US
TelephoneNumber: 5132814400
FaxNumber: 5132814832
Other Information
ProviderEnumerationDate: 11/22/2006
LastUpdateDate: 06/08/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X50-00-1836OHY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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