Provider Demographics
NPI:1689360174
Name:TANNI, SAGIA T (DPM)
Entity Type:Individual
Prefix:
First Name:SAGIA
Middle Name:T
Last Name:TANNI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 HUBBARD ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6214
Mailing Address - Country:US
Mailing Address - Phone:631-829-1862
Mailing Address - Fax:
Practice Address - Street 1:2671 HUBBARD ST FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6214
Practice Address - Country:US
Practice Address - Phone:631-829-1862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program