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General NPI Number Information
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NPI Number | 1083424717
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Entity Type | Individual
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Provider Name | SIERRA EHLERS PA
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Gender | Female
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 200 S ORANGE AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5817
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Country | US
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Telephone | 862-386-4552
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Fax |
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Provider Business Mailing Address
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Address Line | 162 S ORANGE AVE APT 501
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City | NEWARK
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State | NJ
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Zip | 07103-3038
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 25MP00906700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00906700
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License Number State | NJ
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