Healthcare Provider Details

I. General information

NPI: 1306755145
Provider Name (Legal Business Name): SARA AHMAD CHAHROUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 HILLOCK AVE
HAWTHORNE NJ
07506-3440
US

IV. Provider business mailing address

14 HILLOCK AVE
HAWTHORNE NJ
07506-3440
US

V. Phone/Fax

Practice location:
  • Phone: 973-389-3891
  • Fax:
Mailing address:
  • Phone: 973-389-3891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15638200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: