Provider Demographics
NPI:1144240136
Name:ZYSKOWSKI, SARAH S (DO)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:S
Last Name:ZYSKOWSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:S
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD STE A109F
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:909 WILSON RD STE B119
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-6410
Practice Address - Country:US
Practice Address - Phone:517-353-3070
Practice Address - Fax:517-884-1817
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010153712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4900634Medicaid
MII50926Medicare UPIN
MIC36019106Medicare ID - Type Unspecified