Healthcare Provider Details

I. General information

NPI: 1093647547
Provider Name (Legal Business Name): KAREN MONSERRAT SACTA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8710 51ST AVE APT 1R
ELMHURST NY
11373-3910
US

IV. Provider business mailing address

8314 97TH AVE
OZONE PARK NY
11416-1222
US

V. Phone/Fax

Practice location:
  • Phone: 917-398-2588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number035571-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: