MEDICARE: SARAH PIEKARSKY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1447872338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH PIEKARSKY

Provider Business Mailing Address
First Line	:	11 SUNDANCE DR
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-4938
Country	:	US
Telephone Number	:	973-519-0719
Fax Number	:

Provider Business Practice Location Address
First Line	:	1828 W LAKE AVE
Second Line	:
City	:	NEPTUNE CITY
State	:	NJ
Zip	:	07753-4663
Country	:	US
Telephone Number	:	732-775-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	05/13/2020

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