Healthcare Provider Details

I. General information

NPI: 1316713183
Provider Name (Legal Business Name): SARAH KATHARINE GILLETT CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH KATHARINE MARCISAK

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 MAIN ST
NEW PALTZ NY
12561-1612
US

IV. Provider business mailing address

PO BOX 95000-8363
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 845-255-7901
  • Fax:
Mailing address:
  • Phone: 888-445-8745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number002272
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: