Provider Demographics
NPI:1043499981
Name:PESTIEAU, SARAH ROSE (MD)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ROSE
Last Name:PESTIEAU
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Mailing Address - Street 2:DEPARTMENT OF MEDICINE HSC-T16 020
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8160
Mailing Address - Country:US
Mailing Address - Phone:631-444-1106
Mailing Address - Fax:631-444-2493
Practice Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Practice Address - Street 2:DEPARTMENT OF MEDICINE HSC-T16 020
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8160
Practice Address - Country:US
Practice Address - Phone:631-444-1106
Practice Address - Fax:631-444-2493
Is Sole Proprietor?:No
Enumeration Date:2007-10-28
Last Update Date:2010-01-11
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Provider Licenses
StateLicense IDTaxonomies
NY254003207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine