Provider Demographics
NPI:1396873204
Name:SASH, TERRI MADALYN (MA)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:MADALYN
Last Name:SASH
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:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:EAST CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12060-0295
Mailing Address - Country:US
Mailing Address - Phone:518-697-0673
Mailing Address - Fax:212-202-7867
Practice Address - Street 1:491 MAIN ST
Practice Address - Street 2:SUITE #3
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1822
Practice Address - Country:US
Practice Address - Phone:413-553-3182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6290235Z00000X
NY008911-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASP0182OtherBLUE CROSS MA