Healthcare Provider Details

I. General information

NPI: 1245152131
Provider Name (Legal Business Name): SARAH WELLS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 BROADHOLLOW RD STE 200
MELVILLE NY
11747-4833
US

IV. Provider business mailing address

536 ACKERSON BLVD
BRIGHTWATERS NY
11718-1715
US

V. Phone/Fax

Practice location:
  • Phone: 888-722-2072
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number686539
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number686539
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: