Provider Demographics
NPI:1043810518
Name:BUCKLEY, SARAH JEAN (RN)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:JEAN
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 COTTING AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-2941
Mailing Address - Country:US
Mailing Address - Phone:774-245-2627
Mailing Address - Fax:
Practice Address - Street 1:66 COTTING AVE FL 1
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-2941
Practice Address - Country:US
Practice Address - Phone:774-245-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2301176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse