Provider Demographics
NPI:1578827192
Name:MIYAMOTO, SATSUKI
Entity Type:Individual
Prefix:MS
First Name:SATSUKI
Middle Name:
Last Name:MIYAMOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LANDING DR
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1181
Mailing Address - Country:US
Mailing Address - Phone:914-525-2126
Mailing Address - Fax:
Practice Address - Street 1:13 LANDING DR
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1181
Practice Address - Country:US
Practice Address - Phone:914-525-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist