Provider Demographics
NPI:1477668333
Name:SARNATARO, ROBERT EDMUND (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EDMUND
Last Name:SARNATARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 162ND ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1324
Mailing Address - Country:US
Mailing Address - Phone:718-358-6389
Mailing Address - Fax:718-358-9819
Practice Address - Street 1:3229 162ND ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1324
Practice Address - Country:US
Practice Address - Phone:718-358-6389
Practice Address - Fax:718-358-9819
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY62157Medicare ID - Type UnspecifiedGHI MEDICARE
NY41D822Medicare ID - Type UnspecifiedEMPIRE BLUE CROSS MEDICAR
NYA62672Medicare UPIN