Provider Demographics
NPI:1902472491
Name:LONGVER, SABRINA MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:MARIE
Last Name:LONGVER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1064A WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NH
Mailing Address - Zip Code:03870-2336
Mailing Address - Country:US
Mailing Address - Phone:603-759-2398
Mailing Address - Fax:
Practice Address - Street 1:1064A WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NH
Practice Address - Zip Code:03870-2336
Practice Address - Country:US
Practice Address - Phone:603-759-2398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1140225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant