Provider Demographics
NPI:1366265126
Name:MACKAY, SARAH WYNNE (DPT)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:WYNNE
Last Name:MACKAY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HERITAGE LN
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3714
Mailing Address - Country:US
Mailing Address - Phone:914-830-7658
Mailing Address - Fax:
Practice Address - Street 1:4105 FABER PLACE DR STE 420
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8594
Practice Address - Country:US
Practice Address - Phone:843-894-7374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052987225100000X
SC12570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist