Provider Demographics
NPI:1568835353
Name:WROCLAWSKI, SARAH ASHLEY (WHNP-BC, CNM)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ASHLEY
Last Name:WROCLAWSKI
Suffix:
Gender:F
Credentials:WHNP-BC, CNM
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ASHLEY
Other - Last Name:KEATING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:90 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2524
Mailing Address - Country:US
Mailing Address - Phone:860-789-3148
Mailing Address - Fax:
Practice Address - Street 1:300 JUBILEE DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-4030
Practice Address - Country:US
Practice Address - Phone:860-789-3148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19959700363L00000X
MARN2295674363LW0102X
NYF001862-1367A00000X
NJ25ME00064400367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health