Provider Demographics
NPI:1750089157
Name:AGRESTA, SARAH C
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:AGRESTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 BRISTOW CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-9595
Mailing Address - Country:US
Mailing Address - Phone:404-740-1760
Mailing Address - Fax:
Practice Address - Street 1:9555 BRISTOW CT
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-9595
Practice Address - Country:US
Practice Address - Phone:404-740-1760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program