Provider Demographics
NPI:1366799074
Name:MARTOS, SARA ELIZABETH
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:ELIZABETH
Last Name:MARTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 38TH ST
Mailing Address - Street 2:BOX 38-001
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2772
Mailing Address - Country:US
Mailing Address - Phone:212-585-6410
Mailing Address - Fax:
Practice Address - Street 1:257 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4830
Practice Address - Country:US
Practice Address - Phone:845-368-5983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant