Provider Demographics
NPI:1720075542
Name:SIRNA, SARA JEANNE (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JEANNE
Last Name:SIRNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 8277783
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19185-7783
Mailing Address - Country:US
Mailing Address - Phone:215-707-5800
Mailing Address - Fax:215-707-3946
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-5800
Practice Address - Fax:215-707-3946
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051503L207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
094086Medicare ID - Type Unspecified
A03107Medicare UPIN