Provider Demographics
NPI:1306405956
Name:HARDIN, SARA (DO)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:HARDIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 REGENCY CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-1711
Mailing Address - Country:US
Mailing Address - Phone:865-257-2131
Mailing Address - Fax:
Practice Address - Street 1:707 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2667
Practice Address - Country:US
Practice Address - Phone:845-333-6333
Practice Address - Fax:845-333-7342
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022018353207P00000X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program