Provider Demographics
NPI:1457734105
Name:DIAMOND, SARA SCHAFRANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:SCHAFRANN
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 72ND ST APT 29C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4547
Mailing Address - Country:US
Mailing Address - Phone:203-247-3600
Mailing Address - Fax:
Practice Address - Street 1:200 E 72ND ST APT 29C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4547
Practice Address - Country:US
Practice Address - Phone:203-247-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY141397918Medicaid