Sara Loesch, LMSW
Individual provider Active NPI Specialist · Keyport, NJ
NPI 1871041103 · NPPES record last updated Sep 15, 2016
Key facts
- NPI
- 1871041103
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 098307 (NY)
- Practice address
- 162 Maple PL
Keyport, NJ 07735-1346 - Phone
- (732) 978-3128
- NPI assigned
- Sep 15, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 098307 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 098307 | NY | Yes |
Addresses
Primary practice location
162 Maple PL
Keyport, NJ 07735-1346
Mailing address
162 Maple PL
Keyport, NJ 07735-1346
Phone (732) 978-3128
Other providers in Keyport, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.