Provider Demographics
NPI:1609509835
Name:SARDEIRA, CARLA MARINA (CERTIFICATE)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:MARINA
Last Name:SARDEIRA
Suffix:
Gender:F
Credentials:CERTIFICATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 IRA AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-2411
Mailing Address - Country:US
Mailing Address - Phone:179-411-2169
Mailing Address - Fax:
Practice Address - Street 1:602 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7503
Practice Address - Country:US
Practice Address - Phone:212-390-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach