Provider Demographics
NPI:1942540315
Name:SAWYER, DOUGLAS ELMER (MS, ATC)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ELMER
Last Name:SAWYER
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 BENEDICT AVE
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-4327
Mailing Address - Country:US
Mailing Address - Phone:914-366-2695
Mailing Address - Fax:914-366-2633
Practice Address - Street 1:293 BENEDICT AVE
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-4327
Practice Address - Country:US
Practice Address - Phone:914-366-2695
Practice Address - Fax:914-366-2633
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000777-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
921061OtherNATA