Provider Demographics
NPI:1184355406
Name:CARRERA, SAUDY (LOM)
Entity type:Individual
Prefix:
First Name:SAUDY
Middle Name:
Last Name:CARRERA
Suffix:
Gender:F
Credentials:LOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 W TURNER ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5330
Mailing Address - Country:US
Mailing Address - Phone:610-504-3309
Mailing Address - Fax:
Practice Address - Street 1:1633 N 26TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-1805
Practice Address - Country:US
Practice Address - Phone:484-893-0484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOM00313171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist