Provider Demographics
NPI:1750629655
Name:BOOKSHAR, SARAH MICHELLE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
Last Name:BOOKSHAR
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 1:421 FOSTER AVE
Mailing Address - Street 2:APT. B302
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-3578
Mailing Address - Country:US
Mailing Address - Phone:908-652-1242
Mailing Address - Fax:
Practice Address - Street 1:421 FOSTER AVE
Practice Address - Street 2:APT B302
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-3578
Practice Address - Country:US
Practice Address - Phone:908-652-1242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401102940610376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide