Provider Demographics
NPI:1568690659
Name:BOHL, SARAH ALICIA (DNP, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ALICIA
Last Name:BOHL
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ALICIA
Other - Last Name:LAWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:518-525-5634
Mailing Address - Fax:518-649-4094
Practice Address - Street 1:1240 NEW SCOTLAND RD STE 203
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9222
Practice Address - Country:US
Practice Address - Phone:518-478-9423
Practice Address - Fax:518-439-7046
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335963363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03118325Medicaid
NYJ400007089Medicare PIN