Provider Demographics
NPI:1144858051
Name:SARA PASTERNAK LLC
Entity type:Organization
Organization Name:SARA PASTERNAK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTERNAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-694-1945
Mailing Address - Street 1:1 WILLIAM ST APT 534
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3691
Mailing Address - Country:US
Mailing Address - Phone:201-694-1945
Mailing Address - Fax:
Practice Address - Street 1:100 CHALLENGER RD STE 401
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-2114
Practice Address - Country:US
Practice Address - Phone:201-694-1945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-28
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)