Provider Demographics
NPI:1508365610
Name:CANHOTO, SARA (RN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:CANHOTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 PAVONIA AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-2224
Mailing Address - Country:US
Mailing Address - Phone:201-955-2843
Mailing Address - Fax:
Practice Address - Street 1:242 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-2967
Practice Address - Country:US
Practice Address - Phone:973-521-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-04
Last Update Date:2018-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13184000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse