Provider Demographics
NPI:1811057714
Name:SHEPHERD-MELTZER, SARAH BETH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:SHEPHERD-MELTZER
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 1:221 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428-1729
Mailing Address - Country:US
Mailing Address - Phone:845-647-2443
Mailing Address - Fax:845-647-2460
Practice Address - Street 1:221 CANAL ST
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-1729
Practice Address - Country:US
Practice Address - Phone:845-647-2443
Practice Address - Fax:845-647-2460
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator