Provider Demographics
NPI:1447520259
Name:CALABRO, SARA (LAC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:CALABRO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 RIVERSIDE DR
Mailing Address - Street 2:4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-5919
Mailing Address - Country:US
Mailing Address - Phone:917-992-9723
Mailing Address - Fax:
Practice Address - Street 1:1201 BROADWAY STE 1003
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5405
Practice Address - Country:US
Practice Address - Phone:917-992-9723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004392171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist