Provider Demographics
NPI:1144382953
Name:SARNACKI, STANLEY S
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:S
Last Name:SARNACKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 OLD YORKTOWN RD
Mailing Address - Street 2:UNIT # 1
Mailing Address - City:SHRUB OAK
Mailing Address - State:NY
Mailing Address - Zip Code:10588-1516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:330 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4026
Practice Address - Country:US
Practice Address - Phone:718-832-1964
Practice Address - Fax:171-883-2056
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCP01329224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist