Provider Demographics
NPI:1851089528
Name:PINCUS, SASHA REBECCA (LCAT-LP)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:REBECCA
Last Name:PINCUS
Suffix:
Gender:F
Credentials:LCAT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CANDEE AVE
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-3055
Mailing Address - Country:US
Mailing Address - Phone:631-629-2250
Mailing Address - Fax:
Practice Address - Street 1:258 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3512
Practice Address - Country:US
Practice Address - Phone:631-629-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22-553221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist