Provider Demographics
NPI:1073609988
Name:SEARS, DAWN V (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:V
Last Name:SEARS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18725 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-4025
Mailing Address - Country:US
Mailing Address - Phone:718-527-4510
Mailing Address - Fax:718-527-8865
Practice Address - Street 1:187-25 LINDEN BLVD
Practice Address - Street 2:LINDEN BLVD
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-4025
Practice Address - Country:US
Practice Address - Phone:718-527-4510
Practice Address - Fax:718-527-8865
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0045951213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02543924Medicaid
NY02543924Medicaid
NY91930Medicare PIN