Basic Information
Provider Information | |||||||||
NPI: | 1003054552 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SAROS | ||||||||
FirstName: | CATHLEEN | ||||||||
MiddleName: | MARY | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.O. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | MCBURNEY | ||||||||
OtherFirstName: | CATHLEEN | ||||||||
OtherMiddleName: | MARY | ||||||||
OtherNamePrefix: | MISS | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | D.O. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 535 HIGH MOUNTAIN RD | ||||||||
Address2: |   | ||||||||
City: | NORTH HALEDON | ||||||||
State: | NJ | ||||||||
PostalCode: | 075082665 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9736369000 | ||||||||
FaxNumber: | 9736360913 | ||||||||
Practice Location | |||||||||
Address1: | 535 HIGH MOUNTAIN RD | ||||||||
Address2: |   | ||||||||
City: | NORTH HALEDON | ||||||||
State: | NJ | ||||||||
PostalCode: | 075082665 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9736369000 | ||||||||
FaxNumber: | 9736360913 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/21/2009 | ||||||||
LastUpdateDate: | 05/06/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MB06935000 | NJ | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   |
No ID Information.