Provider Demographics
NPI:1649543653
Name:SAFDAR, SARA (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:SAFDAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:171 STRATFORD N
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2343
Mailing Address - Country:US
Mailing Address - Phone:347-322-2284
Mailing Address - Fax:718-693-7770
Practice Address - Street 1:731 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:347-322-2284
Practice Address - Fax:718-693-7770
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265889207R00000X
TN50857207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04019132Medicaid
TNQ002713Medicaid
VA1649543653Medicaid
TNP01312581OtherRAILROAD MEDICARE
NC1649543653Medicaid