Provider Demographics
NPI:1760932164
Name:GOLDBRENER, SARAH N (CCC, SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:N
Last Name:GOLDBRENER
Suffix:
Gender:F
Credentials:CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6307
Mailing Address - Country:US
Mailing Address - Phone:845-356-5756
Mailing Address - Fax:
Practice Address - Street 1:28 RAYMOND AVE
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-6307
Practice Address - Country:US
Practice Address - Phone:845-356-5756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022289-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist