Provider Demographics
NPI:1265424253
Name:EASAW, SARAH J (MD LLC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:EASAW
Suffix:
Gender:F
Credentials:MD LLC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1255 ROUTE 70
Mailing Address - Street 2:31 S
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5900
Mailing Address - Country:US
Mailing Address - Phone:732-961-0010
Mailing Address - Fax:732-961-0013
Practice Address - Street 1:1255 ROUTE 70
Practice Address - Street 2:31 S
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5900
Practice Address - Country:US
Practice Address - Phone:732-961-0010
Practice Address - Fax:732-961-0013
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06274500207R00000X, 207RH0000X
NJMA62745207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2223293OtherAETNA
221900628OtherUNITED HEALTHCARE CIGNA
P1112299OtherOXFORD
F22155Medicare UPIN