Provider Demographics
NPI:1770546947
Name:HARTZOG, SARAH EMILY I (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:EMILY
Last Name:HARTZOG
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 5TH AVE
Mailing Address - Street 2:THE CONTINUUM CENTER FOR HEALTH AND HEALING
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8728
Mailing Address - Country:US
Mailing Address - Phone:646-935-2259
Mailing Address - Fax:646-935-2273
Practice Address - Street 1:245 5TH AVE
Practice Address - Street 2:THE CONTINUUM CENTER FOR HEALTH AND HEALING
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8728
Practice Address - Country:US
Practice Address - Phone:646-935-2244
Practice Address - Fax:646-935-2273
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169506-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO33507OtherSTATE LICENSE NUMBER
SCTL30522OtherSTATE LICENSE
UT48439401200001OtherBCBS PROVIDER NUMBER
CO01335074Medicaid
UT4843940-8905OtherSTATE LICENSE NUMBER
CO38745OtherBCBS PROVIDER NUMBER
CO33507OtherSTATE LICENSE NUMBER
CO01335074Medicaid