1306674346 NPI number — SARAH REED TARLECKI PSYD

Table of content: SARAH REED TARLECKI PSYD (NPI 1306674346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306674346 NPI number — SARAH REED TARLECKI PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TARLECKI
Provider First Name:
SARAH
Provider Middle Name:
REED
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSECKY
Provider Other First Name:
SARAH
Provider Other Middle Name:
REED
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306674346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
356 N POTTSTOWN PIKE FL 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EXTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19341-2246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-469-1798
Provider Business Mailing Address Fax Number:
610-273-5598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
356 N POTTSTOWN PIKE FL 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EXTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19341-2246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-469-1798
Provider Business Practice Location Address Fax Number:
610-273-5598
Provider Enumeration Date:
07/22/2024

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: 103T00000X , with the licence number:  PS020386 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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