Provider Demographics
NPI:1730313149
Name:BURNS, SARI JACLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:SARI
Middle Name:JACLYN
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 W 16TH ST
Mailing Address - Street 2:APT 4TN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6328
Mailing Address - Country:US
Mailing Address - Phone:845-461-4719
Mailing Address - Fax:
Practice Address - Street 1:16 W 16TH ST
Practice Address - Street 2:APT 4TN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6328
Practice Address - Country:US
Practice Address - Phone:845-461-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2672732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program