Healthcare Provider Details

I. General information

NPI: 1053493205
Provider Name (Legal Business Name): SARAH LEI DEL PILAR TANGUILIG R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1538 COUNTRY RIDGE LN
BALTIMORE MD
21221-3906
US

IV. Provider business mailing address

23 ASHLAR HILL CT
BALTIMORE MD
21234-5942
US

V. Phone/Fax

Practice location:
  • Phone: 410-887-0246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberR145440
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: