Provider Demographics
NPI:1659671287
Name:PECENY, SARAH ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:PECENY
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 1:1500 WALTER ST SE
Mailing Address - Street 2:ROOM 220
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-4658
Mailing Address - Country:US
Mailing Address - Phone:505-212-7418
Mailing Address - Fax:
Practice Address - Street 1:1500 WALTER ST SE
Practice Address - Street 2:ROOM 220
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-4658
Practice Address - Country:US
Practice Address - Phone:505-212-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator