Provider Demographics
NPI:1245489764
Name:ECK, SARA L (LPN)
Entity type:Individual
Prefix:MISS
First Name:SARA
Middle Name:L
Last Name:ECK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2693 GENESEE RD
Mailing Address - Street 2:
Mailing Address - City:ARCADE
Mailing Address - State:NY
Mailing Address - Zip Code:14009-9304
Mailing Address - Country:US
Mailing Address - Phone:585-322-0188
Mailing Address - Fax:
Practice Address - Street 1:2693 GENESEE RD
Practice Address - Street 2:
Practice Address - City:ARCADE
Practice Address - State:NY
Practice Address - Zip Code:14009-9304
Practice Address - Country:US
Practice Address - Phone:585-322-0188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285564-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse