Healthcare Provider Details

I. General information

NPI: 1780885509
Provider Name (Legal Business Name): TATIANA SBARRA D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 W 72ND ST
NEW YORK NY
10023-3300
US

IV. Provider business mailing address

324 E 77TH ST # 3C
NEW YORK NY
10021-2466
US

V. Phone/Fax

Practice location:
  • Phone: 212-496-2260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number051465-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: