MEDICARE: MS. FARAH SAINTE PHYSICIAN ASSISTANT

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	363A00000X	Physician Assistant	011786-1	NY

General Provider Information

NPI Number	:	1497972079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FARAH SAINTE PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	19112 120TH RD
Second Line	:
City	:	SAINT ALBANS
State	:	NY
Zip	:	11412-3619
Country	:	US
Telephone Number	:	917-601-1984
Fax Number	:

Provider Business Practice Location Address
First Line	:	19112 120TH RD
Second Line	:
City	:	SAINT ALBANS
State	:	NY
Zip	:	11412-3619
Country	:	US
Telephone Number	:	917-601-1984
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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