Healthcare Provider Details

I. General information

NPI: 1659285500
Provider Name (Legal Business Name): NEW YORK FAMILY DENTISTRY - NASSAU, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 ROUTE 22
BREWSTER NY
10509-4051
US

IV. Provider business mailing address

1549 RINGLING BLVD STE 520
SARASOTA FL
34236-6772
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-4999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: SARAH BALASTER
Title or Position: OWNER
Credential: DMD
Phone: 941-444-0558