Provider Demographics
NPI:1932330099
Name:POOLE, SABRINA ANNETTA
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:ANNETTA
Last Name:POOLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 LAVEROCK RD
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-2816
Mailing Address - Country:US
Mailing Address - Phone:215-884-4496
Mailing Address - Fax:
Practice Address - Street 1:150 SO. INDEPENDENCE MALL WEST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106
Practice Address - Country:US
Practice Address - Phone:215-399-0980
Practice Address - Fax:215-399-0987
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program