Provider Demographics
NPI:1568743540
Name:RIBAK, SARA (MSN,FNP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:RIBAK
Suffix:
Gender:F
Credentials:MSN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EXPRESSWAY PLZ
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2047
Mailing Address - Country:US
Mailing Address - Phone:516-647-8152
Mailing Address - Fax:516-484-6027
Practice Address - Street 1:1 EXPRESSWAY PLZ
Practice Address - Street 2:SUITE 203
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2047
Practice Address - Country:US
Practice Address - Phone:516-647-8152
Practice Address - Fax:516-484-6027
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333009-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily