Healthcare Provider Details

I. General information

NPI: 1134905276
Provider Name (Legal Business Name): SARAH MU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH MORGAN

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 NORTHERN BLVD STE 11
GREAT NECK NY
11021-4802
US

IV. Provider business mailing address

23 ROGERS PL
FLORAL PARK NY
11001-1727
US

V. Phone/Fax

Practice location:
  • Phone: 516-829-0030
  • Fax:
Mailing address:
  • Phone: 516-203-5182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number050898
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: