Basic Information
Provider Information
NPI: 1407388689
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAETTA
FirstName: STEPHANIE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 WESTCHESTER AVE STE N715
Address2:  
City: RYE BROOK
State: NY
PostalCode: 105731376
CountryCode: US
TelephoneNumber: 9146075730
FaxNumber: 9144571195
Practice Location
Address1: 210 WESTCHESTER AVE
Address2:  
City: WHITE PLAINS
State: NY
PostalCode: 106042901
CountryCode: US
TelephoneNumber: 9146826532
FaxNumber: 9146815260
Other Information
ProviderEnumerationDate: 03/28/2017
LastUpdateDate: 11/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X306699NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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