Provider Demographics
NPI:1134332075
Name:CWIAK, SARAH ELISSA (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELISSA
Last Name:CWIAK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 ENCLAVE LN
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-1916
Mailing Address - Country:US
Mailing Address - Phone:908-781-0448
Mailing Address - Fax:
Practice Address - Street 1:404 KING GEORGE RD
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2808
Practice Address - Country:US
Practice Address - Phone:908-647-3206
Practice Address - Fax:908-647-3206
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01166900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist