Provider Demographics
NPI:1982947230
Name:ULLAH, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ULLAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:EEINS, 6TH, 7TH AND 8TH FLOORS
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 WOODBINE LANE
Practice Address - Street 2:EEINS, 6TH, 7TH AND 8TH FLOORS
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-8029
Practice Address - Country:US
Practice Address - Phone:570-271-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD462791207W00000X, 207W00000X
PA390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program