Provider Demographics
NPI:1669527347
Name:BJERKE, SAREETA HELENA (MD)
Entity type:Individual
Prefix:DR
First Name:SAREETA
Middle Name:HELENA
Last Name:BJERKE
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 1:30 E BYWAY
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-3655
Mailing Address - Country:US
Mailing Address - Phone:203-531-4849
Mailing Address - Fax:203-276-7213
Practice Address - Street 1:30 SHELBURNE RD
Practice Address - Street 2:STAMFORD HOSPITAL AMBULATORY CLINIC
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3628
Practice Address - Country:US
Practice Address - Phone:203-276-7145
Practice Address - Fax:203-276-7213
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039827207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT139270Medicare UPIN
CT16001999Medicare ID - Type Unspecified