Healthcare Provider Details

I. General information

NPI: 1124140306
Provider Name (Legal Business Name): SARA MILLER-POJMAN RPAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 10/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 UNDERHILL AVE
YORKTOWN HTS NY
10598-4557
US

IV. Provider business mailing address

4 HUNTER ST
CROTON ON HUDSON NY
10520-1910
US

V. Phone/Fax

Practice location:
  • Phone: 914-962-5501
  • Fax:
Mailing address:
  • Phone: 914-271-9443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001525-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: