Healthcare Provider Details

I. General information

NPI: 1720915523
Provider Name (Legal Business Name): MIKAELA SARGEANT AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 MONTAGUE ST
BROOKLYN NY
11201-3600
US

IV. Provider business mailing address

1159 DEAN ST
BROOKLYN NY
11216-3061
US

V. Phone/Fax

Practice location:
  • Phone: 347-808-7070
  • Fax:
Mailing address:
  • Phone: 832-366-5812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number003362
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: