Healthcare Provider Details

I. General information

NPI: 1790476117
Provider Name (Legal Business Name): SARAH HYMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 JERICHO TPKE
FLORAL PARK NY
11001-2146
US

IV. Provider business mailing address

263 JERICHO TPKE
FLORAL PARK NY
11001-2146
US

V. Phone/Fax

Practice location:
  • Phone: 718-901-8410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number064864
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: