Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 155205 | MA |
N | 111NI0900X | Internist | 155205 | MA |
N | 207RH0000X | Hematologist | 155205 | MA |
NPI | 1306887302 |
---|---|
Provider Name | Dr. Robert Sackstein |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2617 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
155205 | TUFTS HEALTH PLAN (01) | MA |
3186768 | (05) | MA |
D61313 | (02) | |
J19433 | BCBS MA (01) | MA |