Healthcare Provider Details

I. General information

NPI: 1346179884
Provider Name (Legal Business Name): SARA ALYSSA BALSAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2196
US

IV. Provider business mailing address

1217 N ST NW APT T1
WASHINGTON DC
20005-5198
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8766
  • Fax:
Mailing address:
  • Phone: 516-606-6157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: