Provider Demographics
NPI:1609507128
Name:GROSSMAN, SARA LEORA (MSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LEORA
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 DEERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3231
Mailing Address - Country:US
Mailing Address - Phone:646-285-1942
Mailing Address - Fax:
Practice Address - Street 1:295 W ROUTE 59
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5449
Practice Address - Country:US
Practice Address - Phone:845-533-3227
Practice Address - Fax:845-746-9761
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker