Provider Demographics
NPI:1356392088
Name:TIMMAPURI, SARAH L (MD, FACC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:TIMMAPURI
Suffix:
Gender:F
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 ESSEX ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3231
Mailing Address - Country:US
Mailing Address - Phone:201-343-2050
Mailing Address - Fax:201-343-4512
Practice Address - Street 1:211 ESSEX ST
Practice Address - Street 2:SUITE 306
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3231
Practice Address - Country:US
Practice Address - Phone:201-343-2050
Practice Address - Fax:201-343-4512
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05968200207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF70059Medicare UPIN
NJ420804BU4Medicare ID - Type Unspecified