Basic Information
| Provider Information | |||||||||
| NPI: | 1528028438 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEIMROTH | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | |||||||||
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| Credential: | NPP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SWEET | ||||||||
| OtherFirstName: | SARA | ||||||||
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| OtherCredential: | NPP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 20 LEWIS AVE | ||||||||
| Address2: | |||||||||
| City: | GT BARRINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135281845 | ||||||||
| FaxNumber: | 4135283667 | ||||||||
| Practice Location | |||||||||
| Address1: | 2880 RT 9 | ||||||||
| Address2: | |||||||||
| City: | VALATIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187586922 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | F400651 | NY | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.