Provider Demographics
NPI:1831922715
Name:CLINTON, SARAH ASHLEY (PHD, MS, RDN)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ASHLEY
Last Name:CLINTON
Suffix:
Gender:F
Credentials:PHD, MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ELIOT PL
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-5717
Mailing Address - Country:US
Mailing Address - Phone:631-943-2924
Mailing Address - Fax:
Practice Address - Street 1:41 JOHN ST
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2932
Practice Address - Country:US
Practice Address - Phone:631-204-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86373840133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered