MEDICARE: SAI NYSHA LLC

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	28885	SC

General Provider Information

NPI Number	:	1881048114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAI NYSHA LLC

Provider Business Mailing Address
First Line	:	175 TONEY PENNA DR STE 101
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-5747
Country	:	US
Telephone Number	:	914-318-1654
Fax Number	:

Provider Business Practice Location Address
First Line	:	3803 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2720
Country	:	US
Telephone Number	:	561-746-2033
Fax Number	:	561-744-5349

Authorized Official
Title or Position	:	OWNER
Name	:	SANDHYA PATTEM
Credential	:	MD
Telephone Number	:	914-318-1654

Provider Enumeration Date	:	04/23/2016
Last Update Date	:	01/15/2025

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