Provider Demographics
NPI:1043655087
Name:DUKACH, SABRINA (MD)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:DUKACH
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 1:448 NEPTUNE AVE APT 13D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4425
Mailing Address - Country:US
Mailing Address - Phone:516-270-8829
Mailing Address - Fax:
Practice Address - Street 1:355 BARD AVE
Practice Address - Street 2:PEDIATRICS RM 314
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1664
Practice Address - Country:US
Practice Address - Phone:718-818-4636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286607-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics