Back, Sara Deborah

Back, Sara Deborah is an individual health care provider with primary practice located at 3424 Kossuth Ave Rm #3H17, Bronx NY 10467-2410. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Back, Sara Deborah can be contacted via phone (718) 519-3631.

Contact Information

Primary practice address
3424 Kossuth Ave Rm #3H17 Bronx NY 10467-2410
Phone: (718) 519-3631
Fax: (718) 519-2034
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F333271 New York

Profile Details

NPI number 1104811991
LBN Legal business name Back, Sara Deborah
Credentials FNP MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2005
Last updated Jul 9th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104811991 NPPES
New York MEDICAID 02108950

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