Provider Demographics
NPI:1245429190
Name:SPARROW
Entity type:Organization
Organization Name:SPARROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALDOKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-355-3503
Mailing Address - Street 1:5400 MALL DR W
Mailing Address - Street 2:APT 3107
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-3260
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 E MOUNT HOPE AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3207
Practice Address - Country:US
Practice Address - Phone:517-485-1153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087677282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren