Provider Demographics
NPI:1164509998
Name:SARBIB, YEKATERINA (PA)
Entity Type:Individual
Prefix:MS
First Name:YEKATERINA
Middle Name:
Last Name:SARBIB
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:264 WASHINGTON AVENUE EXT STE 201
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-6352
Mailing Address - Country:US
Mailing Address - Phone:518-452-1928
Mailing Address - Fax:518-362-1348
Practice Address - Street 1:264 WASHINGTON AVENUE EXT STE 201
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-6352
Practice Address - Country:US
Practice Address - Phone:518-452-1928
Practice Address - Fax:518-362-1348
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011556363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPA2376Medicare PIN