Healthcare Provider Details

I. General information

NPI: 1992590491
Provider Name (Legal Business Name): SARAH ELIZABETH BOTTJER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 MAIN ST
FISHKILL NY
12524-3520
US

IV. Provider business mailing address

1032 MAIN ST
FISHKILL NY
12524-3520
US

V. Phone/Fax

Practice location:
  • Phone: 845-897-3330
  • Fax:
Mailing address:
  • Phone: 845-897-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: