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General NPI Number Information
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NPI Number | 1619238383
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Entity Type | Individual
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Provider Name | SARAH SERTIAL PAUL D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 100 MADISON AVE FARRIS BUILDING, 4TH FLOOR
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City | MORRISTOWN
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State | NJ
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Zip | 07960
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Country | US
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Telephone | 973-971-4096
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Fax | 973-290-7177
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Provider Business Mailing Address
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Address Line | PO BOX 416457
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City | BOSTON
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State | MA
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Zip | 02241-6457
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Country | US
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Telephone | 844-362-1735
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Fax | 973-290-7495
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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 | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number | 25MB10586800
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License Number State | NJ
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