Healthcare Provider Details

I. General information

NPI: 1548424526
Provider Name (Legal Business Name): SVETLANA SAKIRSKY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3412 36TH ST SUITE 220
ASTORIA NY
11106-1200
US

IV. Provider business mailing address

3412 36TH ST SUITE 220
ASTORIA NY
11106-1200
US

V. Phone/Fax

Practice location:
  • Phone: 718-391-0611
  • Fax: 347-761-3196
Mailing address:
  • Phone: 718-391-0611
  • Fax: 347-761-3196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408300
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number334370
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334370
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: