Provider Demographics
NPI:1023606993
Name:LEFKOWICH, SARAH MELANIE (LAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MELANIE
Last Name:LEFKOWICH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4738 OSAGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-1815
Mailing Address - Country:US
Mailing Address - Phone:518-506-4540
Mailing Address - Fax:
Practice Address - Street 1:4636 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-3854
Practice Address - Country:US
Practice Address - Phone:215-222-2303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000998171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist