Provider Demographics
NPI:1477712719
Name:TAKI, SARA LORENZ I (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LORENZ
Last Name:TAKI
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 MERCER STREET
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012
Mailing Address - Country:US
Mailing Address - Phone:212-677-3400
Mailing Address - Fax:212-995-5897
Practice Address - Street 1:190 MERCER ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1502
Practice Address - Country:US
Practice Address - Phone:212-677-3400
Practice Address - Fax:212-995-5897
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248492207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine