Provider Demographics
NPI:1780133538
Name:POLITO, SARA (PT, DPT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:POLITO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2138 PRIEST BRIDGE CT
Mailing Address - Street 2:STE 7
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2463
Mailing Address - Country:US
Mailing Address - Phone:410-721-6333
Mailing Address - Fax:
Practice Address - Street 1:1919 GREENTREE RD STE B
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1115
Practice Address - Country:US
Practice Address - Phone:856-424-0993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28546225100000X
NJ40QA01910900225100000X
CA292101225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist