Provider Demographics
NPI:1598133969
Name:KASPER, SARAH A
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:KASPER
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 1:3671 HUDSON MANOR TER
Mailing Address - Street 2:APT 7E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1137
Mailing Address - Country:US
Mailing Address - Phone:917-363-6618
Mailing Address - Fax:
Practice Address - Street 1:3671 HUDSON MANOR TER
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1137
Practice Address - Country:US
Practice Address - Phone:917-363-6618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY973938152252Y00000X
NY694867122252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency