Provider Demographics
NPI:1942695879
Name:ROSA, SARA E (OTR)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:ROSA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ARLINGTON ST
Mailing Address - Street 2:APT 1A
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-6129
Mailing Address - Country:US
Mailing Address - Phone:914-393-8714
Mailing Address - Fax:
Practice Address - Street 1:16 ARLINGTON ST
Practice Address - Street 2:APT 1A
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-6129
Practice Address - Country:US
Practice Address - Phone:914-393-8714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019530225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist