Provider Demographics
NPI:1073753034
Name:HERZBERG, SATCEY LYNN
Entity Type:Individual
Prefix:MRS
First Name:SATCEY
Middle Name:LYNN
Last Name:HERZBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16410 41ST AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-2692
Mailing Address - Country:US
Mailing Address - Phone:612-998-8708
Mailing Address - Fax:
Practice Address - Street 1:16410 41ST AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-2692
Practice Address - Country:US
Practice Address - Phone:612-998-8708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLSG280343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)