Provider Demographics
NPI:1528796547
Name:BURNSTEIN, SARAH DEVORA
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:DEVORA
Last Name:BURNSTEIN
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 1:127 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1514
Mailing Address - Country:US
Mailing Address - Phone:917-509-1693
Mailing Address - Fax:
Practice Address - Street 1:127 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1514
Practice Address - Country:US
Practice Address - Phone:917-509-1693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06824600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker