Provider Demographics
NPI:1114245735
Name:ZACK, YAEL SADAN (MD)
Entity Type:Individual
Prefix:
First Name:YAEL
Middle Name:SADAN
Last Name:ZACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LONGVIEW AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-5000
Mailing Address - Country:US
Mailing Address - Phone:914-849-7600
Mailing Address - Fax:914-849-7696
Practice Address - Street 1:2 LONGVIEW AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5000
Practice Address - Country:US
Practice Address - Phone:914-849-7600
Practice Address - Fax:914-849-7696
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256040207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03733704Medicaid