Provider Demographics
NPI:1407266166
Name:BAUER, SARA (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 E 85TH ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4926
Mailing Address - Country:US
Mailing Address - Phone:516-732-9823
Mailing Address - Fax:
Practice Address - Street 1:1228 E 85TH ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4926
Practice Address - Country:US
Practice Address - Phone:516-732-9823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-04
Last Update Date:2014-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-12-12231103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst