1417980012 NPI number — MRS. SARAH J. STROSSMAN MS, CCC-A

Table of content: MRS. SARAH J. STROSSMAN MS, CCC-A (NPI 1417980012)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417980012 NPI number — MRS. SARAH J. STROSSMAN MS, CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STROSSMAN
Provider First Name:
SARAH
Provider Middle Name:
J.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CCC-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARDY
Provider Other First Name:
SARAH
Provider Other Middle Name:
J.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417980012
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 KINGS HWY S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14617-5504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-442-4200
Provider Business Mailing Address Fax Number:
585-244-3519

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 LINDEN OAKS STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-442-4200
Provider Business Practice Location Address Fax Number:
585-244-3519
Provider Enumeration Date:
07/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  001733-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9290097 . This is a "INDEPENDANT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P010001733 . This is a "BLUE CHOICE OF ROCHESTER," identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P020001733 . This is a "BC/BS OF ROCHESTER, NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2600812 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000576123002 . This is a "BC/BS OF WNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00011175701 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 216765AI . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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