Healthcare Provider Details

I. General information

NPI: 1205301272
Provider Name (Legal Business Name): SARAH NARGESS KAZERANI NP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2018
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 PARK ST
MALONE NY
12953-1244
US

IV. Provider business mailing address

2500 DELANO AVE
MIDLAND TX
79701-6357
US

V. Phone/Fax

Practice location:
  • Phone: 518-483-3000
  • Fax:
Mailing address:
  • Phone: 405-476-9794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number817972
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4043029
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP139110
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: