Provider Demographics
NPI:1669515219
Name:SORRENTINO, SARAH PEDDIE (DC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:PEDDIE
Last Name:SORRENTINO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JOAN
Other - Last Name:PEDDIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:8714 E VISTA BONITA DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4249
Mailing Address - Country:US
Mailing Address - Phone:480-247-9063
Mailing Address - Fax:480-247-9974
Practice Address - Street 1:8714 E VISTA BONITA DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4249
Practice Address - Country:US
Practice Address - Phone:480-247-9063
Practice Address - Fax:480-247-9974
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZV12128Medicare UPIN