Provider Demographics
NPI:1720744006
Name:MATTHEWS, SARAH J (LPN)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:J
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 ROBERT DR APT 6
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-5665
Mailing Address - Country:US
Mailing Address - Phone:716-931-4596
Mailing Address - Fax:
Practice Address - Street 1:328 ROBERT DR APT 6
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-5665
Practice Address - Country:US
Practice Address - Phone:716-931-4596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332067164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse