Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251H1200X | Hand | 46TR00172800 | NJ |
Y | 225X00000X | Occupational Therapist | 10941687-4201 | UT |
NPI | 1912980905 |
---|---|
Provider Name | Mrs. Sara J Burman-Newby |
First Address | Nanuet, NY 10954-5238 |
Second Address | Airmont, NY 10952-3420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 03/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004771-1 | NY LICENSE # (01) | NY |