Provider Demographics
NPI:1245339068
Name:TIMIAN, SARAHANNE (SLP)
Entity type:Individual
Prefix:
First Name:SARAHANNE
Middle Name:
Last Name:TIMIAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 CURRY RD EXT.
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303
Mailing Address - Country:US
Mailing Address - Phone:518-836-2200
Mailing Address - Fax:518-836-2201
Practice Address - Street 1:2995 CURRY RD EXT.
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303
Practice Address - Country:US
Practice Address - Phone:518-836-2200
Practice Address - Fax:518-836-2201
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015924235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0104523OtherGHIHMO
10103882OtherCDPHP
NY00015924Medicaid