MEDICARE: DR. ELIZABETH SIROTA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	231277	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255437125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH SIROTA M.D.

Provider Business Mailing Address
First Line	:	514 49TH ST
Second Line	:	SUNSET TERRACE FAMILY HEALTH CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2010
Country	:	US
Telephone Number	:	718-437-2642
Fax Number	:	718-437-5239

Provider Business Practice Location Address
First Line	:	514 49TH ST
Second Line	:	SUNSET TERRACE FAMILY HEALTH CENTER
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2010
Country	:	US
Telephone Number	:	718-437-2642
Fax Number	:	718-437-5239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/13/2021

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