MEDICARE: SARA LEAH TARSIS 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	207N00000X	Dermatology Physician	209269	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	753074313	OTHER	NY	BEECH STREET
2	N82479	OTHER	NY	HEALTHNET-NON PAR
3	P2807514	OTHER	NY	OXFORD
4	3163532	OTHER	NY	AETNA/USHEALTHCARE(HMO)
5	753074313	OTHER	NY	MAGNACARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	209269-N03	OTHER	NY	HIP
8	2K9871	OTHER	NY	B/C &B/S HMO'S
9	753074313	OTHER	NY	PHCS
10	753074313	OTHER	NY	1199
11	2299532	OTHER	NY	GHI
12	5C4849	OTHER	NY	HEALTHNET-PAR
13	7664244	OTHER	NY	AETNA/USHEALTHCARE (PPO)
14	185405	OTHER	NY	ONE HEALTH PLAN (PPO)
15	753074313	OTHER	NY	EMPIRE PLAN

General Provider Information

NPI Number	:	1447204185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA LEAH TARSIS M.D.

Provider Business Mailing Address
First Line	:	4514 16TH AVE FL 4THE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-1101
Country	:	US
Telephone Number	:	718-407-7300
Fax Number	:	718-400-9012

Provider Business Practice Location Address
First Line	:	4514 16TH AVE FL 4THE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-1101
Country	:	US
Telephone Number	:	718-407-7300
Fax Number	:	718-400-9012

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	06/28/2023

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