Provider Demographics
NPI:1700241171
Name:HYATT, SARAH (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HYATT
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 VASSAR RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5451
Mailing Address - Country:US
Mailing Address - Phone:845-264-0849
Mailing Address - Fax:
Practice Address - Street 1:115 DELAFIELD ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1749
Practice Address - Country:US
Practice Address - Phone:845-431-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133964321282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital