Provider Demographics
NPI:1225088867
Name:GILL, SARAH ANNE (PHD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:GILL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2517
Mailing Address - Country:US
Mailing Address - Phone:518-369-3484
Mailing Address - Fax:
Practice Address - Street 1:42 WARREN ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2517
Practice Address - Country:US
Practice Address - Phone:518-369-3484
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015087103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000498427002OtherBLUE SHIELD OF NORTHEASTE
000498427006OtherBLUE SHIELD OF NORTHEASTE
NY02257312Medicaid
000498427002OtherBLUE SHIELD OF NORTHEASTE