Provider Demographics
NPI:1053466185
Name:SACHS, MICHAEL EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EVAN
Last Name:SACHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 CENTRAL PARK S
Mailing Address - Street 2:SUITE 1-D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1565
Mailing Address - Country:US
Mailing Address - Phone:212-315-0333
Mailing Address - Fax:212-586-1794
Practice Address - Street 1:128 CENTRAL PARK S
Practice Address - Street 2:SUITE 1-D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1565
Practice Address - Country:US
Practice Address - Phone:212-315-0333
Practice Address - Fax:212-586-1794
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131958261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO7558Medicare UPIN
NY27A401Medicare ID - Type Unspecified