Provider Demographics
NPI:1558872689
Name:MURDOCH, SARAH ANNA (PTA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNA
Last Name:MURDOCH
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 1:440 SAINT NICHOLAS AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7638
Mailing Address - Country:US
Mailing Address - Phone:254-688-0217
Mailing Address - Fax:
Practice Address - Street 1:133 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4802
Practice Address - Country:US
Practice Address - Phone:212-923-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009958-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant