Provider Demographics
NPI:1356445464
Name:DISTEFANO, SARINA J (MD)
Entity type:Individual
Prefix:
First Name:SARINA
Middle Name:J
Last Name:DISTEFANO
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:755 N BROADWAY STE 560
Mailing Address - Street 2:SLEEPY HOLLOW MEDICAL GROUP AT PHELPS
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-1077
Mailing Address - Country:US
Mailing Address - Phone:914-631-0337
Mailing Address - Fax:914-631-0552
Practice Address - Street 1:755 N BROADWAY STE 560
Practice Address - Street 2:SLEEPY HOLLOW MEDICAL GROUP AT PHELPS
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1077
Practice Address - Country:US
Practice Address - Phone:914-631-0337
Practice Address - Fax:914-631-0552
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2011-03-09
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Provider Licenses
StateLicense IDTaxonomies
NY150224207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00858177Medicaid
NY28D15Medicare ID - Type Unspecified
NY00858177Medicaid