Provider Demographics
NPI:1235500935
Name:FEDER, SARAH BETH (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:BETH
Last Name:FEDER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 CLUB RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-2118
Mailing Address - Country:US
Mailing Address - Phone:203-273-3401
Mailing Address - Fax:
Practice Address - Street 1:57 UNION PL
Practice Address - Street 2:SUITE #315
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2568
Practice Address - Country:US
Practice Address - Phone:908-273-5537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00827500235Z00000X
NY025170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist