Healthcare Provider Details

I. General information

NPI: 1245111954
Provider Name (Legal Business Name): SARAH BECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 10/24/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 MADISON AVE
NEW YORK NY
10029-6508
US

IV. Provider business mailing address

79 CRAGMERE RD
AIRMONT NY
10901-7524
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-5566
  • Fax:
Mailing address:
  • Phone: 518-495-1106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number433404
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: