Healthcare Provider Details

I. General information

NPI: 1922652775
Provider Name (Legal Business Name): SARAH BUZALEWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH STIANSEN

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 FALLON AVE
SEAFORD DE
19973-1577
US

IV. Provider business mailing address

49 FALLON AVE
SEAFORD DE
19973-1577
US

V. Phone/Fax

Practice location:
  • Phone: 302-629-5030
  • Fax:
Mailing address:
  • Phone: 302-629-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberLJ-0010422
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: