Healthcare Provider Details

I. General information

NPI: 1336522333
Provider Name (Legal Business Name): SARAH DANIELLE ZUCKERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WEST 42ND STREET
NEW YORK NY
10036
US

IV. Provider business mailing address

1590 GARY ST
EAST MEADOW NY
11554-2909
US

V. Phone/Fax

Practice location:
  • Phone: 516-532-1267
  • Fax:
Mailing address:
  • Phone: 516-532-1267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV008300
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: