Provider Demographics
NPI:1447204185
Name:TARSIS, SARA LEAH (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LEAH
Last Name:TARSIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4514 16TH AVE FL 4THE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1101
Mailing Address - Country:US
Mailing Address - Phone:718-407-7300
Mailing Address - Fax:718-400-9012
Practice Address - Street 1:4514 16TH AVE FL 4THE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-1101
Practice Address - Country:US
Practice Address - Phone:718-407-7300
Practice Address - Fax:718-400-9012
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2023-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY209269207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY753074313OtherBEECH STREET
NYN82479OtherHEALTHNET-NON PAR
NYP2807514OtherOXFORD
NY3163532OtherAETNA/USHEALTHCARE(HMO)
NY753074313OtherMAGNACARE
NY02090288Medicaid
NY209269-N03OtherHIP
NY2K9871OtherB/C &B/S HMO'S
NY753074313OtherPHCS
NY753074313Other1199
NY2299532OtherGHI
NY5C4849OtherHEALTHNET-PAR
NY7664244OtherAETNA/USHEALTHCARE (PPO)
NY185405OtherONE HEALTH PLAN (PPO)
NY753074313OtherEMPIRE PLAN
NY753074313OtherPHCS
NY753074313OtherBEECH STREET