1750392700 NPI number — MRS. TATYANA SAYKO MD

Table of content: MRS. TATYANA SAYKO MD (NPI 1750392700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750392700 NPI number — MRS. TATYANA SAYKO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAYKO
Provider First Name:
TATYANA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750392700
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
813 SOUTHBRIDGE STREET
Provider Second Line Business Mailing Address:
SAINT VINCENT MEDICAL GROUP IN AUBURN
Provider Business Mailing Address City Name:
AUBURN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01501-1332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-832-0173
Provider Business Mailing Address Fax Number:
508-832-6479

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
813 SOUTHBRIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01501-1323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-363-0173
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  220387 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 220387 . This is a "LIC #" identifier . This identifiers is of the category "OTHER".
  • Identifier: J27569 . This is a "BCBS QUINCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110080910A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3565556 . This is a "CIGNA AVON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 469027 . This is a "TUFTS HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 86313 . This is a "FALLON HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA13152 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042103577 . This is a "HMH TAX ID #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3568021 . This is a "AETNA BLUE BELL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042103577 . This is a "CONSOLIDATED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 220019 . This is a "MEDICARE B" identifier . This identifiers is of the category "OTHER".
  • Identifier: 971043 . This is a "NETWORK HEALTH" identifier . This identifiers is of the category "OTHER".




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