1205066925 NPI number — SARAH AUGUSTA KASDAN M.S. OTR/L

Table of content: DR. JIMENA MARIA GOMEZ DEL CARPIO M.D. (NPI 1619173614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205066925 NPI number — SARAH AUGUSTA KASDAN M.S. OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KASDAN
Provider First Name:
SARAH
Provider Middle Name:
AUGUSTA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S. OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MATTHEWS
Provider Other First Name:
SARAH
Provider Other Middle Name:
AUGUSTA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS OTR/L
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1205066925
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1345 ENTERPRISE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST CHESTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19380-5964
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2765 JEFFERSON DAVIS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STAFFORD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22554-8331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-446-5323
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  0131000542 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com