MEDICARE: SAYAN A GRAHAM ARNP

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	363L00000X	Nurse Practitioner	9270980	FL

General Provider Information

NPI Number	:	1922506476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAYAN A GRAHAM ARNP

Provider Business Mailing Address
First Line	:	3304 NW 29TH CT
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-1105
Country	:	US
Telephone Number	:	954-729-7706
Fax Number	:

Provider Business Practice Location Address
First Line	:	3304 NW 29TH CT
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-1105
Country	:	US
Telephone Number	:	954-729-7706
Fax Number	:

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

Provider Enumeration Date	:	01/30/2018
Last Update Date	:	11/27/2020

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