Basic Information
| Provider Information | |||||||||
| NPI: | 1972227619 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHELAN | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 228 E 27TH ST APT 4C | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100169245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316265730 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15050 14TH RD | ||||||||
| Address2: | |||||||||
| City: | WHITESTONE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113572609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187670071 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2022 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.