Provider Demographics
NPI:1356475925
Name:PRAGLE, SARAH MARIE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:PRAGLE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:25 ELLAS AVE
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:NY
Mailing Address - Zip Code:14810-1107
Mailing Address - Country:US
Mailing Address - Phone:607-776-3301
Mailing Address - Fax:
Practice Address - Street 1:25 ELLAS AVE
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-1107
Practice Address - Country:US
Practice Address - Phone:607-776-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026832-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist