Provider Demographics
NPI:1023404555
Name:SANO, ELIZABETH ANN (APRN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:SANO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:BOTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:324 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3804
Mailing Address - Country:US
Mailing Address - Phone:937-776-2799
Mailing Address - Fax:
Practice Address - Street 1:625 W RIDGE PIKE STE 300
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1180
Practice Address - Country:US
Practice Address - Phone:610-825-1994
Practice Address - Fax:610-825-2949
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN724709363LP0200X
OHRN399351363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics