Provider Demographics
NPI:1679760326
Name:BARNES, SARAH L (CDN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:L
Last Name:BARNES
Suffix:
Gender:F
Credentials:CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4449 HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-1135
Mailing Address - Country:US
Mailing Address - Phone:718-994-2044
Mailing Address - Fax:347-427-1418
Practice Address - Street 1:1441 OLD NORTHERN BLVD
Practice Address - Street 2:BEACON THERAPY SERVICES, PLLC
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576
Practice Address - Country:US
Practice Address - Phone:516-625-6846
Practice Address - Fax:516-625-0238
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004079-1133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist