Provider Demographics
NPI:1164407227
Name:SACARIN, ROXANA TEODORA
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:TEODORA
Last Name:SACARIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROXANA
Other - Middle Name:TEODORA
Other - Last Name:GHEORGHIV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 MOTOR PARKWAY
Mailing Address - Street 2:SUITE LL8
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788
Mailing Address - Country:US
Mailing Address - Phone:833-547-7463
Mailing Address - Fax:631-248-5583
Practice Address - Street 1:1000 MONTAUK HWY
Practice Address - Street 2:GOOD SAMARITAN HOSPITAL
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4927
Practice Address - Country:US
Practice Address - Phone:833-547-7463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215595207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02103299Medicaid
NY84I761Medicare ID - Type Unspecified
NY02103299Medicaid