Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 343177 | NY |
NPI | 1003302928 |
---|---|
Provider Name | Mrs. Sarah Hardy |
First Address | St Johnsville, NY 13452-1332 |
Second Address | St Johnsville, NY 13452-1332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2018 |
Last Update Date | 24/05/2021 |