Healthcare Provider Details

I. General information

NPI: 1003711060
Provider Name (Legal Business Name): SARA SANTANA ATC, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA CARPENTIERI

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 KINDERKAMACK RD
RIVER EDGE NJ
07661-2140
US

IV. Provider business mailing address

146 LINDEN ST
HACKENSACK NJ
07601-4612
US

V. Phone/Fax

Practice location:
  • Phone: 201-992-0174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: