Provider Demographics
NPI:1225642598
Name:BAE, SARAH HYUNJI (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:HYUNJI
Last Name:BAE
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 164TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2750
Mailing Address - Country:US
Mailing Address - Phone:800-275-8777
Mailing Address - Fax:
Practice Address - Street 1:4003 164TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2750
Practice Address - Country:US
Practice Address - Phone:800-275-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant