| Doctor Name: | MS. SARAH WALLIS |
| NPI Number: | 1063794659 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN CNM WHNP-BC |
| License Number: | 26NJ00343800 |
| Business Practice Address: | 5301 Broadway West New York, NJ - 070932622 |
| Business Phone Number: | 2018669320 |
| Business Fax Number: | |
| Mailing Address: | 800 31 Street, UNION CITY |
| State: | NJ |
| Postal Code: | 07087 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/09/2011 |
| NPI Last Update Date: | 03/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 26NJ00343800 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |