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General NPI Number Information
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NPI Number | 1124735568
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Entity Type | Individual
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Provider Name | SARA ISGAR LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 1000 HEMPSTEAD AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1135
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Country | US
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Telephone | 516-323-3606
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Fax |
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Provider Business Mailing Address
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Address Line | 504 BEACH 133RD ST APT 1
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City | BELLE HARBOR
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State | NY
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Zip | 11694-1418
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 003889-01
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License Number State | NY
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