Provider Demographics
NPI:1417206228
Name:TOMPKINS, SARA ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ELIZABETH
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SUTTON PL
Mailing Address - Street 2:APT 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3181
Mailing Address - Country:US
Mailing Address - Phone:516-297-7738
Mailing Address - Fax:
Practice Address - Street 1:4 SUTTON PL
Practice Address - Street 2:APT 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3181
Practice Address - Country:US
Practice Address - Phone:516-297-7738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY543539163WH0200X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WH0200XNursing Service ProvidersRegistered NurseHome Health