Provider Demographics
NPI:1720846298
Name:VARGAS, SARAH JEAN (RN, BSN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:VARGAS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEAN
Other - Last Name:MACKENZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1807 ELMWOOD AVE APT 115
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-2469
Mailing Address - Country:US
Mailing Address - Phone:716-957-7637
Mailing Address - Fax:
Practice Address - Street 1:1010 E AND WEST RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3602
Practice Address - Country:US
Practice Address - Phone:716-677-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY737633163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent