Provider Demographics
NPI:1871285411
Name:CYRUS, SABINE
Entity type:Individual
Prefix:
First Name:SABINE
Middle Name:
Last Name:CYRUS
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 1:801 HEMPSTEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-2331
Mailing Address - Country:US
Mailing Address - Phone:516-688-4304
Mailing Address - Fax:
Practice Address - Street 1:801 HEMPSTEAD BLVD
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-2331
Practice Address - Country:US
Practice Address - Phone:516-688-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker