Provider Demographics
NPI:1427437557
Name:PIVARUNAS, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:PIVARUNAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 FRENCH RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4808
Mailing Address - Country:US
Mailing Address - Phone:716-668-3434
Mailing Address - Fax:716-668-4904
Practice Address - Street 1:1231 FRENCH RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4808
Practice Address - Country:US
Practice Address - Phone:716-668-3434
Practice Address - Fax:716-668-4904
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist