Provider Demographics
NPI:1245484302
Name:BALOCH, SARAH JANE (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:JANE
Last Name:BALOCH
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 PIONEER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-1610
Mailing Address - Country:US
Mailing Address - Phone:347-342-6937
Mailing Address - Fax:
Practice Address - Street 1:71 SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-1600
Practice Address - Country:US
Practice Address - Phone:718-330-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-15
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014745-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist