Provider Demographics
NPI:1780912634
Name:FRUNZI, SARA L
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:FRUNZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11740 FISH POND RD
Mailing Address - Street 2:
Mailing Address - City:PINE CITY
Mailing Address - State:NY
Mailing Address - Zip Code:14871-9412
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11740 FISH POND RD
Practice Address - Street 2:
Practice Address - City:PINE CITY
Practice Address - State:NY
Practice Address - Zip Code:14871-9412
Practice Address - Country:US
Practice Address - Phone:607-329-6378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08155811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical