Provider Demographics
NPI:1548424526
Name:SAKIRSKY, SVETLANA (NP)
Entity Type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:
Last Name:SAKIRSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 36TH ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1200
Mailing Address - Country:US
Mailing Address - Phone:718-391-0611
Mailing Address - Fax:347-761-3196
Practice Address - Street 1:3412 36TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-1200
Practice Address - Country:US
Practice Address - Phone:718-391-0611
Practice Address - Fax:347-761-3196
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334370363LF0000X
NY334370363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF3343701OtherNEW LICENSE