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General NPI Number Information
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NPI Number | 1790163996
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Entity Type | Organization
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Legal Business Name | TAMARA ANNA MARIE SAUKIN MD PC
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 1920 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2551
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Country | US
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Telephone | 718-355-5557
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Fax | 718-351-5559
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Provider Business Mailing Address
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Address Line | 1920 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2551
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Country | US
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Telephone | 718-355-5557
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Fax | 718-351-5559
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAMARA SAUKIN
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Credential | MD
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Telephone | 718-355-5557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 241180
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License Number State | NY
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