1285935064 NPI number — SARAH L. HART, PH.D., LLC

Table of content: (NPI 1285935064)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285935064 NPI number — SARAH L. HART, PH.D., LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SARAH L. HART, PH.D., LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SARAH L HART, PHD, LP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285935064
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
475 CLEVELAND AVE N STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55104-5053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-802-9164
Provider Business Mailing Address Fax Number:
888-899-1514

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
475 CLEVELAND AVE N STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55104-5053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-802-9164
Provider Business Practice Location Address Fax Number:
888-899-1514
Provider Enumeration Date:
11/09/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HART
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
612-802-9164

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  LP5592 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC1900X , with the licence number: LP5592 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)