Provider Demographics
NPI:1568424034
Name:GAER, SASHA MIHAIL (NP)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:MIHAIL
Last Name:GAER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 W CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1351
Mailing Address - Country:US
Mailing Address - Phone:845-232-5590
Mailing Address - Fax:845-232-5588
Practice Address - Street 1:69 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1351
Practice Address - Country:US
Practice Address - Phone:845-232-5590
Practice Address - Fax:845-232-5588
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333862363L00000X, 363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02396147Medicaid
NY02396147Medicaid
NY2E9811Medicare PIN