Healthcare Provider Details

I. General information

NPI: 1518880004
Provider Name (Legal Business Name): SARAH KIDD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

40 MARKET ST APT 209
MORRISTOWN NJ
07960-5460
US

IV. Provider business mailing address

40 MARKET ST APT 209
MORRISTOWN NJ
07960-5460
US

V. Phone/Fax

Practice location:
  • Phone: 404-786-1425
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA13255900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: