Provider Demographics
NPI:1497957807
Name:SHELDON, SARA (PTA)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:SHELDON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 SIERRA LARGA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-6568
Mailing Address - Country:US
Mailing Address - Phone:505-271-7084
Mailing Address - Fax:
Practice Address - Street 1:6320 RIVERSIDE PLAZA LN NW STE 150B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1710
Practice Address - Country:US
Practice Address - Phone:505-884-2032
Practice Address - Fax:505-553-7300
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-0364225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant