Provider Demographics
NPI:1083916324
Name:DEFREITAS-LINDSAY, SATECHA LATOYA (PA)
Entity Type:Individual
Prefix:
First Name:SATECHA
Middle Name:LATOYA
Last Name:DEFREITAS-LINDSAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SATECHA
Other - Middle Name:
Other - Last Name:DEFREITAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:871 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-1901
Mailing Address - Country:US
Mailing Address - Phone:718-791-3548
Mailing Address - Fax:718-798-7825
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:MONTEFIORE MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-8958
Practice Address - Fax:718-798-7825
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014348363A00000X
MDC07691363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant