Provider Demographics
NPI:1558942110
Name:SUTRYK, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SUTRYK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 RENIFF RD
Mailing Address - Street 2:
Mailing Address - City:LOCKWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14859-9646
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:907 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14904-2633
Practice Address - Country:US
Practice Address - Phone:607-767-6497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor