Provider Demographics
NPI:1841487238
Name:HELGESON, SARAH SUSAN (OD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:SUSAN
Last Name:HELGESON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2294 STATE ROUTE 208 # 7
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-2217
Mailing Address - Country:US
Mailing Address - Phone:845-778-3591
Mailing Address - Fax:845-255-1201
Practice Address - Street 1:2294 STATE ROUTE 208 # 7
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-2217
Practice Address - Country:US
Practice Address - Phone:845-778-3591
Practice Address - Fax:845-255-1201
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006714152W00000X
MA4606152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11453625OtherCAQH
NYA400022294Medicare PIN