Healthcare Provider Details

I. General information

NPI: 1871365031
Provider Name (Legal Business Name): SARA LIBA DEUTSCH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 NOSTRAND AVE
BROOKLYN NY
11210-4730
US

IV. Provider business mailing address

2555 NOSTRAND AVE
BROOKLYN NY
11210-4730
US

V. Phone/Fax

Practice location:
  • Phone: 718-951-8800
  • Fax: 718-951-0846
Mailing address:
  • Phone: 718-951-8800
  • Fax: 718-951-0846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: