Provider Demographics
NPI:1851345086
Name:TABBY, SARA MARKS (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARKS
Last Name:TABBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E CITY AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1115
Mailing Address - Country:US
Mailing Address - Phone:610-206-3194
Mailing Address - Fax:484-434-8919
Practice Address - Street 1:555 E CITY AVE STE 400
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1115
Practice Address - Country:US
Practice Address - Phone:610-206-3184
Practice Address - Fax:484-434-8919
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030543E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation