Provider Demographics
NPI:1528508892
Name:SLADER-WALDORF, SARAH A (FNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:SLADER-WALDORF
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:CUTHBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2231 BURDETT AVENUE, STE 160
Mailing Address - Street 2:CAPITAL CARDIOLOGY ASSOCIATES, PC
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2466
Mailing Address - Country:US
Mailing Address - Phone:518-292-6200
Mailing Address - Fax:518-292-6228
Practice Address - Street 1:1205 TROY SCHENECTADY RD STE 101
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-1074
Practice Address - Country:US
Practice Address - Phone:518-348-3176
Practice Address - Fax:844-206-7424
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341363363LF0000X
NY646723163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110125655AMedicaid
NY04831403Medicaid
VT1031140Medicaid