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General NPI Number Information
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NPI Number | 1205297520
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Entity Type | Individual
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Provider Name | SARIT BLACKSTEIN PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/14/2016
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 175-61 HILLSIDE AVENUE SUITE 404
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone | 718-526-6226
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Fax |
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Provider Business Mailing Address
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Address Line | 1078 FORDHAM LN
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City | WOODMERE
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State | NY
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Zip | 11598-1016
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Country | US
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Telephone | 516-456-0765
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 019338-1
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License Number State | NY
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