Basic Information
| Provider Information | |||||||||
| NPI: | 1649692526 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALVATORE | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | LASKEY | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 COUNTRY CLUB RD | ||||||||
| Address2: | |||||||||
| City: | QUEENSBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128041702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5189262005 | ||||||||
| FaxNumber: | 5189262020 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 COUNTRY CLUB RD | ||||||||
| Address2: | |||||||||
| City: | QUEENSBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128041702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5189262005 | ||||||||
| FaxNumber: | 5189262020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2014 | ||||||||
| LastUpdateDate: | 12/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/10/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 20830 | MA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 038234 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.