Provider Demographics
NPI:1922295138
Name:LALLY, SARA E (MD)
Entity Type:Individual
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First Name:SARA
Middle Name:E
Last Name:LALLY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:840 WALNUT STREET
Mailing Address - Street 2:SUITE 1440
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-928-3105
Mailing Address - Fax:215-928-1140
Practice Address - Street 1:840 WALNUT STREET
Practice Address - Street 2:SUITE 1440
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-928-3105
Practice Address - Fax:215-928-1140
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
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Provider Licenses
StateLicense IDTaxonomies
PAMD426201207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology