Provider Demographics
NPI:1013422211
Name:MARTINKO, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MARTINKO
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 1:3957 CORNELL WOODS DR W
Mailing Address - Street 2:A
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-3768
Mailing Address - Country:US
Mailing Address - Phone:330-559-2994
Mailing Address - Fax:
Practice Address - Street 1:3957 CORNELL WOODS DR W
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-3768
Practice Address - Country:US
Practice Address - Phone:330-559-2994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-10
Last Update Date:2017-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program