Provider Demographics
NPI:1982790127
Name:DEUTSCH, SARA (PHD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3736 HENRY HUDSON PKWY
Mailing Address - Street 2:STE. 206
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1502
Mailing Address - Country:US
Mailing Address - Phone:914-965-3501
Mailing Address - Fax:914-965-3329
Practice Address - Street 1:59 FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-1709
Practice Address - Country:US
Practice Address - Phone:914-965-3501
Practice Address - Fax:914-965-3329
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009321-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01643003Medicaid
NY01643003Medicaid