Provider Demographics
NPI:1922488170
Name:GERSTEIN, SARA (MA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:GERSTEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17154 46TH AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3306
Mailing Address - Country:US
Mailing Address - Phone:516-456-2019
Mailing Address - Fax:
Practice Address - Street 1:17154 46TH AVE
Practice Address - Street 2:APT 2
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3306
Practice Address - Country:US
Practice Address - Phone:516-456-2019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist