Healthcare Provider Details

I. General information

NPI: 1720474166
Provider Name (Legal Business Name): SARAH ELIZABETH VATER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 WARREN ST
NEW YORK NY
10007
US

IV. Provider business mailing address

11 PARK PL STE 1200
NEW YORK NY
10007-2823
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-7666
  • Fax: 212-202-7988
Mailing address:
  • Phone: 212-226-7666
  • Fax: 212-202-7988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number292405
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: