Provider Demographics
NPI:1972653475
Name:SAREZKY, MICHAEL NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NEIL
Last Name:SAREZKY
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 1:37 GLENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2913
Mailing Address - Country:US
Mailing Address - Phone:203-964-0771
Mailing Address - Fax:
Practice Address - Street 1:37 GLENBROOK RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2913
Practice Address - Country:US
Practice Address - Phone:203-964-0771
Practice Address - Fax:
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
CT0227082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry