Healthcare Provider Details

I. General information

NPI: 1427136928
Provider Name (Legal Business Name): SHARON CUDAHY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BROAD ST
SCHUYLERVILLE NY
12871-1024
US

IV. Provider business mailing address

201 CHURCH ST
SARATOGA SPRINGS NY
12866-1009
US

V. Phone/Fax

Practice location:
  • Phone: 518-695-3668
  • Fax: 518-695-3614
Mailing address:
  • Phone: 518-580-2022
  • Fax: 518-584-0466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number006537
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: