Provider Demographics
NPI:1841506904
Name:LACARRUBBA, SARAH ANNE (DO)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANNE
Last Name:LACARRUBBA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:MAZURKEVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1345 RXR PLZ FL 13
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11556-1301
Mailing Address - Country:US
Mailing Address - Phone:516-453-0435
Mailing Address - Fax:646-846-3283
Practice Address - Street 1:14 W 14TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7524
Practice Address - Country:US
Practice Address - Phone:410-703-0991
Practice Address - Fax:212-390-0906
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268992207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY390200000XOtherSTUDENT