Provider Demographics
NPI:1366804395
Name:GIEWONT, SARAH ANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:GIEWONT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3188 IRADELL RD
Mailing Address - Street 2:APT. 1
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-9205
Mailing Address - Country:US
Mailing Address - Phone:607-351-3546
Mailing Address - Fax:
Practice Address - Street 1:302 W BUFFALO ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4124
Practice Address - Country:US
Practice Address - Phone:607-274-2209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020265225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics