Healthcare Provider Details

I. General information

NPI: 1932024577
Provider Name (Legal Business Name): SARAH DOMSCHINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FLINT ROAD
MILLBROOK NY
12545-5134
US

IV. Provider business mailing address

306 CEDAR LN
CHESHIRE CT
06410-2222
US

V. Phone/Fax

Practice location:
  • Phone: 845-677-8550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number011092
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: