Provider Demographics
NPI:1851635593
Name:SINA, GOLAREH (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:GOLAREH
Middle Name:
Last Name:SINA
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 ROCKAWAY TPKE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1833
Mailing Address - Country:US
Mailing Address - Phone:516-239-1800
Mailing Address - Fax:516-239-5553
Practice Address - Street 1:222 ROCKAWAY TPKE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1833
Practice Address - Country:US
Practice Address - Phone:516-239-1800
Practice Address - Fax:516-239-5553
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016265363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical