1316122690 NPI number — MRS. SARAH ELIZABETH GANGINIS SCHAEFFER RD,LDN

Table of content: MRS. SARAH ELIZABETH GANGINIS SCHAEFFER RD,LDN (NPI 1316122690)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316122690 NPI number — MRS. SARAH ELIZABETH GANGINIS SCHAEFFER RD,LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GANGINIS SCHAEFFER
Provider First Name:
SARAH
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RD,LDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GANGINIS
Provider Other First Name:
SARAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RD,LDN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316122690
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3734 COLLEGE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLICOTT CITY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21043-4650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-213-9472
Provider Business Mailing Address Fax Number:
410-480-5191

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3734 COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLICOTT CITY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21043-4650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-213-9472
Provider Business Practice Location Address Fax Number:
410-480-5191
Provider Enumeration Date:
01/04/2008

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: 133V00000X , with the licence number:  DX2769 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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