Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 028490 | NY |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 028490 | NY |
N | 1223X0008X | Oral and Maxillofacial Radiology | 028490 | NY |
N | 1223X0400X | Orthodontists | 028490 | NY |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 028490 | NY |
NPI | 1437114931 |
---|---|
Provider Name | Dr. Stephen Alan Sachs |
First Address | Lake Success, NY 11042-1011 |
Second Address | Lake Success, NY 11042-1011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 26/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00501157 | (05) | NY |
T50408 | (02) | NY |