MEDICARE: DR. SARAH M RICKETTS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	199301	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295803781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH M RICKETTS MD

Provider Business Mailing Address
First Line	:	415 W HILL RD
Second Line	:
City	:	MORRIS
State	:	NY
Zip	:	13808-2156
Country	:	US
Telephone Number	:	914-330-3291
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 W HILL RD
Second Line	:
City	:	MORRIS
State	:	NY
Zip	:	13808-2156
Country	:	US
Telephone Number	:	914-330-3291
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	04/23/2024

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