Healthcare Provider Details

I. General information

NPI: 1528748290
Provider Name (Legal Business Name): SARAH HOBERMAN WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 N MAIN ST
NEW SQUARE NY
10977-8916
US

IV. Provider business mailing address

728 N MAIN ST
NEW SQUARE NY
10977-8916
US

V. Phone/Fax

Practice location:
  • Phone: 845-354-9300
  • Fax: 845-517-1924
Mailing address:
  • Phone: 845-354-9300
  • Fax: 845-517-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421646
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: