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NPI Code Detail

MEDICARE: DR. SABRINA MARYLYNE GRATIA D.O

MEDICARE:  DR. SABRINA MARYLYNE GRATIA  D.O
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
12084P0804XChild & Adolescent Psychiatry Physician279890NY
22084P0800XPsychiatry Physician279890NY

General Provider Information

NPI Number : 1386936367
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SABRINA MARYLYNE GRATIA D.O
Provider Business Mailing Address
First Line : 760 BROADWAY DEPT OF
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5383
Country : US
Telephone Number : 187-963-8000
Fax Number :
Provider Business Practice Location Address
First Line : 760 BROADWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-5383
Country : US
Telephone Number : 187-963-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2011
Last Update Date : 06/30/2020

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