Provider Demographics
NPI:1447038567
Name:TOMASIEWICZ, SARAH ELIZABETH (MPH, RD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:TOMASIEWICZ
Suffix:
Gender:F
Credentials:MPH, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 N RUTLAND AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:WI
Mailing Address - Zip Code:53521-9212
Mailing Address - Country:US
Mailing Address - Phone:608-293-0468
Mailing Address - Fax:
Practice Address - Street 1:343 N RUTLAND AVE UNIT B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:WI
Practice Address - Zip Code:53521-9212
Practice Address - Country:US
Practice Address - Phone:608-293-0468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86073612133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered