Provider Demographics
NPI:1427457670
Name:BOSTON, SARAH (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:BOSTON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BLACKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:26908 INDEPENDENCE WAY # 201
Mailing Address - Street 2:
Mailing Address - City:EVANS MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:13637-3300
Mailing Address - Country:US
Mailing Address - Phone:315-629-6255
Mailing Address - Fax:
Practice Address - Street 1:26908 INDEPENDENCE WAY # 201
Practice Address - Street 2:
Practice Address - City:EVANS MILLS
Practice Address - State:NY
Practice Address - Zip Code:13637-3300
Practice Address - Country:US
Practice Address - Phone:315-629-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0379372251P0200X, 225100000X
NCP15183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics