Provider Demographics
NPI:1497722326
Name:YADLOSKY, SARAH E (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:YADLOSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:CEBULAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:701 OSTRUM ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1155
Mailing Address - Country:US
Mailing Address - Phone:484-526-6545
Mailing Address - Fax:484-526-6546
Practice Address - Street 1:701 OSTRUM ST
Practice Address - Street 2:SUITE 601
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1155
Practice Address - Country:US
Practice Address - Phone:484-526-6545
Practice Address - Fax:484-526-6546
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052406363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097471Medicare PIN
PAQ61356Medicare UPIN
PA097471JH4Medicare ID - Type Unspecified