Healthcare Provider Details

I. General information

NPI: 1740683093
Provider Name (Legal Business Name): SARAH TYNDALL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 01/02/2022
Certification Date: 01/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 PASSAIC AVE
SUMMIT NJ
07901-1200
US

IV. Provider business mailing address

2167 HUNTINGTON LN
EASTON PA
18040-8400
US

V. Phone/Fax

Practice location:
  • Phone: 908-897-4056
  • Fax:
Mailing address:
  • Phone: 973-393-2496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00525500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: