Provider Demographics
NPI:1336694843
Name:SIRIAMONTHEP, SARIN (OD)
Entity type:Individual
Prefix:DR
First Name:SARIN
Middle Name:
Last Name:SIRIAMONTHEP
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 WANTAGH AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3917
Mailing Address - Country:US
Mailing Address - Phone:516-712-5966
Mailing Address - Fax:
Practice Address - Street 1:2185 WANTAGH AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3917
Practice Address - Country:US
Practice Address - Phone:516-785-3900
Practice Address - Fax:516-541-4250
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008473152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist