=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285515080
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANABEL SANCHEZ TAVERAS PA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2025
-----------------------------------------------------
Last Update Date | 09/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1540 ROUTE 202 STE 7
-----------------------------------------------------
City | POMONA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10970-2922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-613-3333
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27 SCENIC DR APT E
-----------------------------------------------------
City | CROTON ON HUDSON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10520-1823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-382-4945
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | 034509
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------