Basic Information
Provider Information
NPI: 1023040185
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LENTZ
FirstName: SARAH
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 295 STONER AVE
Address2: STE 102
City: WESTMINSTER
State: MD
PostalCode: 21157
CountryCode: US
TelephoneNumber: 4108481818
FaxNumber: 4108763156
Practice Location
Address1: 295 STONER AVE
Address2: STE 102
City: WESTMINSTER
State: MD
PostalCode: 21157
CountryCode: US
TelephoneNumber: 4108481818
FaxNumber: 4108763156
Other Information
ProviderEnumerationDate: 07/07/2006
LastUpdateDate: 05/16/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XD0063815MDY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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