Provider Demographics
NPI:1396452322
Name:FISHER, SARA JO
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JO
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JO
Other - Last Name:FRIEDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 WITZEL CT
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2848
Mailing Address - Country:US
Mailing Address - Phone:845-578-4088
Mailing Address - Fax:
Practice Address - Street 1:45 WITZEL CT
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2848
Practice Address - Country:US
Practice Address - Phone:845-578-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist