Provider Demographics
NPI:1669481842
Name:SIVITZ, SARAH K (MSPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:K
Last Name:SIVITZ
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8165 CYPRUS CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-5559
Mailing Address - Country:US
Mailing Address - Phone:410-799-0818
Mailing Address - Fax:410-799-2653
Practice Address - Street 1:8165 CYPRUS CEDAR LN
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-5559
Practice Address - Country:US
Practice Address - Phone:410-799-0818
Practice Address - Fax:410-799-2653
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 27020225100000X
MD23431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1053320325OtherTYPE 2NPI
CAZZZ29361ZOtherMEDICARE GROUP PTAN
CAOPT270200Medicare UPIN