Healthcare Provider Details

I. General information

NPI: 1053143727
Provider Name (Legal Business Name): SARA J VENTH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7460 COUNTY HIGHWAY 23
SIDNEY CENTER NY
13839-2149
US

IV. Provider business mailing address

7460 COUNTY HIGHWAY 23
SIDNEY CENTER NY
13839-2149
US

V. Phone/Fax

Practice location:
  • Phone: 607-287-3125
  • Fax:
Mailing address:
  • Phone: 607-287-3125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number870843-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: