Provider Demographics
NPI:1275866618
Name:WECKERLY, SARAH ELLEN
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELLEN
Last Name:WECKERLY
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 1:118 WELSH RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2242
Mailing Address - Country:US
Mailing Address - Phone:215-517-1000
Mailing Address - Fax:
Practice Address - Street 1:118 WELSH RD UNIT B
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2242
Practice Address - Country:US
Practice Address - Phone:215-517-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054110363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical