Healthcare Provider Details

I. General information

NPI: 1386534394
Provider Name (Legal Business Name): SIERRA THOMPSON M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 OLD COUNTRY RD STE C103N
WESTBURY NY
11590-5156
US

IV. Provider business mailing address

9410 239TH ST FL 1
FLORAL PARK NY
11001-3823
US

V. Phone/Fax

Practice location:
  • Phone: 516-284-1519
  • Fax:
Mailing address:
  • Phone: 929-733-1895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: