Provider Demographics
NPI:1326573833
Name:SANBORN, SARAH (LAC, LMT)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:SANBORN
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2733 FRDRK DGLSS BLVD APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3091
Mailing Address - Country:US
Mailing Address - Phone:610-246-0465
Mailing Address - Fax:
Practice Address - Street 1:2733 FRDRK DGLSS BLVD APT 5A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-3091
Practice Address - Country:US
Practice Address - Phone:610-246-0465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-23
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005949171100000X
NY024287225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist