Provider Demographics
NPI:1407062581
Name:STANGOTA, SARAH J (OTR)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:STANGOTA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 STIRRUP LN
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-3438
Mailing Address - Country:US
Mailing Address - Phone:908-625-8090
Mailing Address - Fax:
Practice Address - Street 1:36 STIRRUP LN
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-3438
Practice Address - Country:US
Practice Address - Phone:908-625-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00251800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist