Provider Demographics
NPI:1598732232
Name:BENCH, SARAH ALICE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ALICE
Last Name:BENCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E 57TH ST
Mailing Address - Street 2:APT. 7H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2615
Mailing Address - Country:US
Mailing Address - Phone:917-446-3172
Mailing Address - Fax:
Practice Address - Street 1:19 W 34TH ST
Practice Address - Street 2:PH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3006
Practice Address - Country:US
Practice Address - Phone:917-446-3172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015090103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY015090OtherLICENSE NUMBER
NYVL8651Medicare ID - Type UnspecifiedPROVIDER NUMBER
NYP73321Medicare UPIN