Basic Information
Provider Information
NPI: 1346663143
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUNNINGHAM
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 1094 LOCKSLEY CT
Address2:  
City: WEST DEPTFORD
State: NJ
PostalCode: 080963116
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1 COOPER PLZ
Address2:  
City: CAMDEN
State: NJ
PostalCode: 081031461
CountryCode: US
TelephoneNumber: 8563422000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/29/2014
LastUpdateDate: 01/29/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X26NJ00483300NJY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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