Healthcare Provider Details

I. General information

NPI: 1669750006
Provider Name (Legal Business Name): MICHIE SATO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 05/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 GRAND ST FL 2
NEW YORK NY
10002-4800
US

IV. Provider business mailing address

465 GRAND ST FL 2
NEW YORK NY
10002-4800
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-1999
  • Fax: 212-420-1910
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number078943
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: