Provider Demographics
NPI:1538293733
Name:SARITA DORSCHUG D.O. P.C.
Entity Type:Organization
Organization Name:SARITA DORSCHUG D.O. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:K
Authorized Official - Last Name:DORSCHUG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-231-3535
Mailing Address - Street 1:652 SUFFOLK AVE.
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717
Mailing Address - Country:US
Mailing Address - Phone:631-231-3535
Mailing Address - Fax:631-231-3561
Practice Address - Street 1:652 SUFFOLK AVE.
Practice Address - Street 2:SUITE 208
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-4305
Practice Address - Country:US
Practice Address - Phone:631-231-3535
Practice Address - Fax:631-231-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203811207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty