Healthcare Provider Details

I. General information

NPI: 1477130649
Provider Name (Legal Business Name): FALAK SANA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S OCEAN AVE
PATCHOGUE NY
11772-3700
US

IV. Provider business mailing address

96 BURR RD
EAST NORTHPORT NY
11731-5336
US

V. Phone/Fax

Practice location:
  • Phone: 631-815-3300
  • Fax:
Mailing address:
  • Phone: 631-815-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number331556-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: