Provider Demographics
NPI:1760172142
Name:TOMAINO, SARA MEGHAN (LPN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MEGHAN
Last Name:TOMAINO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417-419 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350
Mailing Address - Country:US
Mailing Address - Phone:518-603-0263
Mailing Address - Fax:518-935-9065
Practice Address - Street 1:417-419 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350
Practice Address - Country:US
Practice Address - Phone:518-603-0263
Practice Address - Fax:518-935-9065
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2859785164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse