Provider Demographics
NPI:1023401577
Name:AMY, SARA O
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:O
Last Name:AMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WESTCHESTER AVE APT 1M
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-3518
Mailing Address - Country:US
Mailing Address - Phone:014-993-5140
Mailing Address - Fax:
Practice Address - Street 1:12 WESTCHESTER AVE APT 1M
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3518
Practice Address - Country:US
Practice Address - Phone:014-993-5140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator