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General NPI Number Information
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NPI Number | 1619671385
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Entity Type | Individual
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Provider Name | SARAYA YASMINE BAKHSH
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Gender | Female
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 358 MADISON ST
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City | WATERVILLE
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State | NY
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Zip | 13480-1116
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Country | US
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Telephone | 315-841-4973
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Fax | 315-841-4963
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Provider Business Mailing Address
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Address Line | 111 HOSPITAL DR
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City | UTICA
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State | NY
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Zip | 13502-2517
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Country | US
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Telephone | 315-801-8848
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 032914
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License Number State | NY
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