MS. SARA DEBORAH BACK (NPI# 1104811991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104811991 |
| Entity Type | Individual |
| Full Name | MS. SARA DEBORAH BACK |
| Credential | FNP MPH |
| Practice Address |
3424 Kossuth Ave Rm #3h17 Bronx NY 10467-2410 |
| Mailing Address |
80 Lasalle St 9c New York NY 10027-4713 |
| Practice Telephone | 7185193631 |
| Practice Fax Number | 7185192034 |
| Mailing Telephone | 2123162445 |
| Enumeration Date | 2005-09-17 |
| Last Update Date | 2008-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
F333271 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02108950 | 05 |
| Street Address |
3424 KOSSUTH AVE RM #3H17 |
| City | BRONX |
| State | NY |
| Zip Code | 10467-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467061101 | Michail Kladas | Student in an Organized Health Care Education/Training Program | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2020-07-29 |
| 1447874698 | Tarsis Damaris Gotay-ihonor | Social Worker | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2020-06-03 |
| 1225666746 | Pegah Kahaliardabili | Student in an Organized Health Care Education/Training Program | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2020-03-30 |
| 1588291512 | North Central Bronx Hospital | Internal Medicine | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2020-03-27 |
| 1619500063 | Salvatore Joseph Milazzo | Physician Assistant | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2020-02-13 |
| 1366072431 | Jessica Batinjane | Psychologist | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2020-01-17 |
| 1447898440 | Brian Connolly | Pharmacist | 3424 Kossuth Ave, Bronx, NY 10467-2489 | 2019-12-20 |
| 1750925343 | Mya Niccole Twyman | Physician Assistant | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2019-11-06 |
| 1265089767 | Hanif Gulamani | Social Worker | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2019-08-20 |
| 1912551029 | Suzannah Johnston | Advanced Practice Midwife | 3424 Kossuth Ave, Bronx, NY 10467-2410 | 2019-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535505 | Maxwell Ennist | Massage Therapist | 210 Bedford Park Blvd, Bronx, NY 10467 | 2020-10-09 |
| 1144854431 | Ny Metro Dental, PC | Dentist | 55 Mosholu Parkway North, Bronx, NY 10467 | 2020-02-26 |
| 1386277960 | Rhonda Ellen Nayberg | Occupational Therapist | Montefiore Medical Center Occupational Therapy Dept, 111 E 210 Street Ground Floor Blue Zone, Bronx, NY 10467 | 2020-02-21 |
| 1013568153 | Jaime Luis Betancourt | Nurse Practitioner | Sickle Cell Clinic, 3400 Bainbridge Avenue, Bronx, NY 10467 | 2019-09-20 |
| 1023662616 | Bronx Jewish Community Council Home Attendant Services | Home Health | 2930 Wallace Ave., Bronx, NY 10467 | 2019-07-31 |
| 1831755321 | Felix Medrano | Taxi | 3106 Webster Ave, Bronx, NY 10467 | 2019-05-10 |
| 1700363108 | Danaies Guzman | Occupational Therapist | 2410 Barker Avenue Apt 11a, Bronx, New York, NY 10467 | 2018-07-27 |
| 1538672175 | Carolina Duque-toro | Speech-Language Pathologist | 4251, 341 E 207th St, Bronx, NY 10467 | 2017-11-06 |
| 1255853727 | Jessica Perkiss | Social Worker | 750 Tilden St., Astor Services for Children and Families, Bronx, NY 10467 | 2017-07-17 |
| 1386166221 | Erica Santos | Licensed Practical Nurse | 3273 Parkside Place, Apt 5g, Bronx, NY 10467 | 2017-07-12 |
| Find all providers in zip 10467 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013258 | Iris Massiel Garcia | Nurse Practitioner | 2206 Dr Martin L King Jr Blvd, Bronx, NY 10453-1307 | 2020-11-04 |
| 1659986701 | Yvette Rosemary Veras | Nurse Practitioner | 3400 Paul Ave Apt 20h, Bronx, NY 10468-1015 | 2020-09-14 |
| 1740894302 | Ajirioghene Ojadi | Nurse Practitioner | 100 Casals Pl Apt 6b, Bronx, NY 10475-3007 | 2020-09-01 |
| 1225641129 | Nancilyma Aidoo | Nurse Practitioner | 1880 Lafayette Ave Apt 20e, Bronx, NY 10473-2721 | 2020-08-28 |
| 1639780679 | Julia Donahue | Nurse Practitioner | 860 Grand Concourse Apt 7h, Bronx, NY 10451-2818 | 2020-08-13 |
| 1053920348 | Genesis Castro | Nurse Practitioner | 2194 Barnes Ave Apt A9, Bronx, NY 10462-1929 | 2020-07-23 |
| 1356969299 | Antoinette G Palmer | Nurse Practitioner | 4015 Wilder Ave, Bronx, NY 10466-2328 | 2020-07-07 |
| 1932726528 | Beena Dacosta | Nurse Practitioner | 3725 Blackstone Avenue, Apt 7e, Bronx, NY 10463 | 2020-06-29 |
| 1124640792 | Violet Nkasiobi Nnaemeka | Nurse Practitioner | 2420 Westchester Ave, Bronx, NY 10461-3569 | 2020-05-17 |
| 1033731260 | Diane Loubeau | Nurse Practitioner | 944 E 233rd St, Bronx, NY 10466-3218 | 2020-05-11 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.