Provider Demographics
NPI:1669098919
Name:MATEO, SARA (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MATEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:MATEO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1427 VINE ST FL 8
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1040
Mailing Address - Country:US
Mailing Address - Phone:267-507-6581
Mailing Address - Fax:
Practice Address - Street 1:1427 VINE ST FL 8
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1040
Practice Address - Country:US
Practice Address - Phone:610-383-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT2217772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry