Basic Information
Provider Information
NPI: 1003144056
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TODD
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 480 BEDFORD RD
Address2:  
City: CHAPPAQUA
State: NY
PostalCode: 105141715
CountryCode: US
TelephoneNumber: 9144588756
FaxNumber: 9144588871
Practice Location
Address1: 480 BEDFORD RD
Address2:  
City: CHAPPAQUA
State: NY
PostalCode: 10514
CountryCode: US
TelephoneNumber: 9144588756
FaxNumber: 9144588871
Other Information
ProviderEnumerationDate: 12/03/2009
LastUpdateDate: 12/05/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X030005-1NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X12012CTN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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