Healthcare Provider Details

I. General information

NPI: 1639031362
Provider Name (Legal Business Name): SARAH ELIZABETH DOMINKO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1379 N RIVER RD
YARDLEY PA
19067-1327
US

IV. Provider business mailing address

1379 N RIVER RD
YARDLEY PA
19067-1327
US

V. Phone/Fax

Practice location:
  • Phone: 302-344-3591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN646763
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: