Provider Demographics
NPI:1851350813
Name:CONBOY, SARAH-RUTH H (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARAH-RUTH
Middle Name:H
Last Name:CONBOY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SYCAMORE WALK
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-1923
Mailing Address - Country:US
Mailing Address - Phone:518-593-7156
Mailing Address - Fax:
Practice Address - Street 1:150 BURNETTS WAY STE 230
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8168
Practice Address - Country:US
Practice Address - Phone:757-942-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
VA2305215644225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT794158OtherMVP
VT00059792OtherBCBS
VT794158OtherMVP