Organization
CAROL SASPORTAS MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL SASPORTAS MD (OWNER PHYSICIAN)
(718) 454-2500
Entity
Organization
Contact information
Practice address
7568 187TH ST, FRESH MEADOWS, NY 11366-1726
(718) 454-2500
(718) 454-8500
Mailing address
7568 187TH ST, FRESH MEADOWS, NY 11366-1726
(718) 454-2500
(718) 454-8500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
195407
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001SF1
MEDICARE ID TYPE UNSPECIFIED
NY
05
—
02573462
—
NY
Enumeration date
09/04/2008
Last updated
06/26/2012
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