Provider Demographics
NPI:1356634786
Name:LITTLE, SARA J (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:J
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:PORT JERVIS
Mailing Address - State:NY
Mailing Address - Zip Code:12771-2027
Mailing Address - Country:US
Mailing Address - Phone:845-672-3995
Mailing Address - Fax:845-373-3111
Practice Address - Street 1:11 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:PORT JERVIS
Practice Address - State:NY
Practice Address - Zip Code:12771
Practice Address - Country:US
Practice Address - Phone:845-672-3995
Practice Address - Fax:845-373-3111
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08822700208000000X
NY262617208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics