Provider Demographics
NPI:1851115513
Name:SAPKO, HALEY ALEXIS
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ALEXIS
Last Name:SAPKO
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 1:243 BURNSIDE PL
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1701
Mailing Address - Country:US
Mailing Address - Phone:724-469-1659
Mailing Address - Fax:
Practice Address - Street 1:123 METRO BLVD
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-6101
Practice Address - Country:US
Practice Address - Phone:973-761-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR25468900163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience