Individual
SARAH TACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 JOHN STREET, NASSAU, NY 12123
(518) 207-2624
(518) 766-9548
Mailing address
4 JOHN STREET, NASSAU, NY 12123
(518) 207-2624
(518) 766-9548
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
501619-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01409145
—
NY
Enumeration date
01/06/2012
Last updated
01/06/2012
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