Provider Demographics
NPI:1124120134
Name:BURELLE, SARA KATHLEEN (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:KATHLEEN
Last Name:BURELLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1632
Mailing Address - Country:US
Mailing Address - Phone:610-648-1293
Mailing Address - Fax:610-993-0364
Practice Address - Street 1:11 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1632
Practice Address - Country:US
Practice Address - Phone:610-648-1293
Practice Address - Fax:610-993-0364
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD062298L2083X0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA005932Medicare ID - Type Unspecified
G63962Medicare UPIN