Provider Demographics
NPI:1760531420
Name:SARLIN, MORTON BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:MORTON
Middle Name:BRUCE
Last Name:SARLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E 87TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1043
Mailing Address - Country:US
Mailing Address - Phone:212-369-4848
Mailing Address - Fax:212-410-0833
Practice Address - Street 1:55 E 87TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1043
Practice Address - Country:US
Practice Address - Phone:212-369-4848
Practice Address - Fax:212-410-0833
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY85005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB15880Medicare UPIN
NY30E871Medicare ID - Type Unspecified