Healthcare Provider Details

I. General information

NPI: 1205598067
Provider Name (Legal Business Name): SARAH ROSE FIELD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ROSE EVENOSKY

II. Dates (important events)

Enumeration Date: 10/08/2021
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 KINGS HIGHWAY SOUTH, BUILDING 5
CHERRY HILL NJ
08034-2500
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-374-4440
  • Fax: 856-374-4445
Mailing address:
  • Phone: 856-374-4440
  • Fax: 856-374-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00643900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MP00643900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number25MP00643900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: