Healthcare Provider Details

I. General information

NPI: 1053773945
Provider Name (Legal Business Name): SARAH GELLMAN LCSW CASAC-2
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8045 WINCHESTER BLVD BLDG 73
QUEENS VILLAGE NY
11427-2195
US

IV. Provider business mailing address

8045 WINCHESTER BLVD BLDG 73
QUEENS VILLAGE NY
11427-2195
US

V. Phone/Fax

Practice location:
  • Phone: 718-264-3970
  • Fax:
Mailing address:
  • Phone: 718-264-3970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089202
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: