Provider Demographics
NPI:1720215239
Name:FARREN, SABRINA ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:ANN
Last Name:FARREN
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 1:921 FERNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1338
Mailing Address - Country:US
Mailing Address - Phone:856-840-0818
Mailing Address - Fax:
Practice Address - Street 1:1700 WYNWOOD DR
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2440
Practice Address - Country:US
Practice Address - Phone:856-829-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00248600225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant