Provider Demographics
NPI:1194191437
Name:GHIZZONI, SARAH A (PT/OT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:GHIZZONI
Suffix:
Gender:F
Credentials:PT/OT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1397
Mailing Address - Country:US
Mailing Address - Phone:614-890-6555
Mailing Address - Fax:614-823-8881
Practice Address - Street 1:5040 FOREST DR STE 300
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8166
Practice Address - Country:US
Practice Address - Phone:614-890-6555
Practice Address - Fax:614-823-8881
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.016072225100000X
OHOT.008821225X00000X
OHPT016072225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH465900OtherPT MEDICARE PTAN
OHH466470OtherOT MEDICARE PTAN
OHH465900OtherPT MEDICARE PTAN
OHH466470OtherOT MEDICARE PTAN