Healthcare Provider Details

I. General information

NPI: 1770470056
Provider Name (Legal Business Name): SARAH A JACOPINO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 SUNSET AVE
UTICA NY
13502-5649
US

IV. Provider business mailing address

111 HOSPITAL DR
UTICA NY
13502-2517
US

V. Phone/Fax

Practice location:
  • Phone: 315-624-8150
  • Fax: 315-797-1537
Mailing address:
  • Phone: 315-624-6101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF357034
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: