Healthcare Provider Details

I. General information

NPI: 1225837891
Provider Name (Legal Business Name): SARAH ELIZABETH BRUTOSKY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 OLD SHORT HILLS RD
LIVINGSTON NJ
07039-5672
US

IV. Provider business mailing address

14-05 MORLOT AVE
FAIR LAWN NJ
07410-1699
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-5938
  • Fax:
Mailing address:
  • Phone: 201-274-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15113700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: