Provider Demographics
NPI:1285026682
Name:KRAHE, SAM (MTBC)
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:KRAHE
Suffix:
Gender:M
Credentials:MTBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10909 MAY RD
Mailing Address - Street 2:
Mailing Address - City:WATTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16442-9602
Mailing Address - Country:US
Mailing Address - Phone:814-881-5181
Mailing Address - Fax:
Practice Address - Street 1:10909 MAY RD
Practice Address - Street 2:
Practice Address - City:WATTSBURG
Practice Address - State:PA
Practice Address - Zip Code:16442-9602
Practice Address - Country:US
Practice Address - Phone:814-881-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist