Provider Demographics
NPI:1003413121
Name:BACKOF, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BACKOF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360557
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-6557
Mailing Address - Country:US
Mailing Address - Phone:915-444-5460
Mailing Address - Fax:915-225-3745
Practice Address - Street 1:12201 MONTWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2620
Practice Address - Country:US
Practice Address - Phone:915-444-5460
Practice Address - Fax:915-225-3745
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1011378363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner