Healthcare Provider Details

I. General information

NPI: 1376110619
Provider Name (Legal Business Name): EMMA THERESE SARRETT MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 MEDFORD AVE
PATCHOGUE NY
11772-1281
US

IV. Provider business mailing address

700 HICKSVILLE RD STE 205
BETHPAGE NY
11714-3472
US

V. Phone/Fax

Practice location:
  • Phone: 631-758-1910
  • Fax: 631-758-2371
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number029967-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: