Provider Demographics
NPI:1740371004
Name:WOOD, SARAH LEE (MSPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LEE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LEE
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:1001 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-9703
Mailing Address - Country:US
Mailing Address - Phone:315-519-5724
Mailing Address - Fax:315-493-0105
Practice Address - Street 1:2416 CONSTITUTION AVE
Practice Address - Street 2:REHABILITATION TODAY
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760
Practice Address - Country:US
Practice Address - Phone:716-372-2808
Practice Address - Fax:716-372-2902
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017689225100000X
NY026847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
223616077OtherNORTH AMERICAN HEALTH PLA
223616077OtherMPN EMPIRE PLAN
000000087331OtherGHIHMO
NY02631125Medicaid
000628022001OtherWNYBCBS
223616077OtherTRICARE
00011264701OtherUNIVERA
223616077OtherFIDELIS
6697264OtherGHI
223616077OtherNOVA
223616077OtherTRICARE