Provider Demographics
NPI:1295195782
Name:KRANZLER, SARA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:KRANZLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3872
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14852
Mailing Address - Country:US
Mailing Address - Phone:551-265-8883
Mailing Address - Fax:
Practice Address - Street 1:903 HANSHAW RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:315-497-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-26
Last Update Date:2021-08-20
Deactivation Date:2019-05-21
Deactivation Code:
Reactivation Date:2019-08-09
Provider Licenses
StateLicense IDTaxonomies
NY020892103T00000X
NY020892-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist