Provider Demographics
NPI:1578144390
Name:OSTRENKO, SARA AINSLEY
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:AINSLEY
Last Name:OSTRENKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BOUNTIFUL DR
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-5100
Mailing Address - Country:US
Mailing Address - Phone:908-892-9081
Mailing Address - Fax:
Practice Address - Street 1:100 BROADWAY # 4
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-3025
Practice Address - Country:US
Practice Address - Phone:908-892-9081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16768300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse