Provider Demographics
NPI:1922312628
Name:ARISTY, SARY MARIELL (MD)
Entity Type:Individual
Prefix:DR
First Name:SARY
Middle Name:MARIELL
Last Name:ARISTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARY
Other - Middle Name:MARIELL
Other - Last Name:GOBAIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1415 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3521
Practice Address - Country:US
Practice Address - Phone:201-837-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09566100207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology