Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 165519 | NY |
N | 207RI0200X | Infectious Disease | 165519 | NY |
NPI | 1194763946 |
---|---|
Provider Name | Dr. Anne C Sacks-Berg |
First Address | Huntington, NY 11743-2743 |
Second Address | Huntington, NY 11743-2743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 14/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A61182 | (02) |