MEDICARE: DR. SARA RACHEL SIRKIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	104165	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225033236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARA RACHEL SIRKIN MD

Provider Business Mailing Address
First Line	:	2441 SHERIDAN DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-9405
Country	:	US
Telephone Number	:	716-836-8700
Fax Number	:	716-446-9198

Provider Business Practice Location Address
First Line	:	2441 SHERIDAN DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-9405
Country	:	US
Telephone Number	:	716-836-8700
Fax Number	:	716-446-9198

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/29/2008

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