Provider Demographics
NPI:1851485171
Name:SARKAR, MAYA (MD)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:SARKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LODGE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3924
Mailing Address - Country:US
Mailing Address - Phone:516-466-7750
Mailing Address - Fax:718-359-9361
Practice Address - Street 1:4245 KISSENA BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3243
Practice Address - Country:US
Practice Address - Phone:718-359-6526
Practice Address - Fax:718-359-9361
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145548208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics