Provider Demographics
NPI:1184176380
Name:GREENE, SARAH ROSE (BS, BSN, NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ROSE
Last Name:GREENE
Suffix:
Gender:F
Credentials:BS, BSN, NP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ROSE
Other - Last Name:FELDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 S. 11TH STREET
Mailing Address - Street 2:35E MICU
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-955-7074
Mailing Address - Fax:
Practice Address - Street 1:834 WALNUT STREET
Practice Address - Street 2:SUITE 650
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-955-5161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN620792163WC0200X
PASP016810363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care MedicineGroup - Multi-Specialty