Boujida, Sarah
Boujida, Sarah is an individual health care provider with primary practice located at 1174 Route 112 , Port Jefferson Station NY 11776-8033. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Boujida, Sarah can be contacted via phone (631) 642-9090.Contact Information
Primary practice address
1174 Route 112
Port Jefferson Station NY 11776-8033
Phone: (631) 642-9090
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 026509 | New York |
Profile Details
| NPI number | 1104409093 |
|---|---|
| LBN Legal business name | Boujida, Sarah |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 29th, 2021 |
| Last updated | Apr 29th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104409093 | NPPES |
| New York | Other | 026509 | NYS LICENSE |
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