Provider Demographics
NPI:1346569381
Name:NSIBIRWA, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NSIBIRWA
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 1:711 CONSHOHOCKEN STATE RD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2103
Mailing Address - Country:US
Mailing Address - Phone:610-949-0493
Mailing Address - Fax:
Practice Address - Street 1:540 CITY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4190
Practice Address - Country:US
Practice Address - Phone:215-877-2116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041283R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist