Provider Demographics
NPI:1063187581
Name:CAMARDELLO, SARAH LYNN
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:CAMARDELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 MARION AVE APT 406
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-8561
Mailing Address - Country:US
Mailing Address - Phone:315-723-8144
Mailing Address - Fax:
Practice Address - Street 1:136 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-5150
Practice Address - Country:US
Practice Address - Phone:518-234-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF348069-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily