Individual
SARA GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM,CRNP
Contact information
Practice address
665 SARATOGA RD, SUITE 100, GANSEVOORT, NY 12831-1599
(518) 363-8815
(518) 363-8831
Mailing address
665 SARATOGA RD, SUITE 100, GANSEVOORT, NY 12831-1599
(518) 363-8815
(518) 363-8831
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
421238
NY
367A00000X
Advanced Practice Midwife
Primary
001706
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
417108236A
—
GA
01
—
581397572
TAX ID #
—
Enumeration date
03/09/2006
Last updated
04/28/2024
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