Provider Demographics
NPI: | 1912490699 |
---|---|
Name: | HUSS, SARAH |
Entity Type: | Individual |
Prefix: | |
First Name: | SARAH |
Middle Name: | |
Last Name: | HUSS |
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: | 57 S HOWELL AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | CENTEREACH |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11720-4327 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 299 HALLOCK AVE |
Practice Address - Street 2: | |
Practice Address - City: | PORT JEFF STA |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11776-1217 |
Practice Address - Country: | US |
Practice Address - Phone: | 631-473-4284 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2018-06-07 |
Last Update Date: | 2018-06-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | |
No | 174400000X | Other Service Providers | Specialist | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |