Provider Demographics
NPI:1184700395
Name:SAUNDERS, DEBORAH (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 JERICHO TURNPIKE
Mailing Address - Street 2:SUITE 175
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2984
Mailing Address - Country:US
Mailing Address - Phone:516-216-5910
Mailing Address - Fax:516-216-5907
Practice Address - Street 1:77 JERICHO TURNPIKE
Practice Address - Street 2:SUITE 175
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2984
Practice Address - Country:US
Practice Address - Phone:516-216-5910
Practice Address - Fax:516-216-5907
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139473208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
F41615Medicare UPIN