Provider Demographics
NPI:1821708231
Name:TOMKIEWICZ, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TOMKIEWICZ
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 1:13 HATHAWAY ST
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01220-1009
Mailing Address - Country:US
Mailing Address - Phone:413-770-7331
Mailing Address - Fax:
Practice Address - Street 1:208 WEST ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5703
Practice Address - Country:US
Practice Address - Phone:413-442-1562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician