Provider Demographics
NPI:1194851667
Name:SHARON SAKA ASSOCIATES INC.
Entity Type:Organization
Organization Name:SHARON SAKA ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKA
Authorized Official - Suffix:
Authorized Official - Credentials:RD CDN
Authorized Official - Phone:845-357-0166
Mailing Address - Street 1:2 EXECUTIVE BLVD
Mailing Address - Street 2:STE 203
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901
Mailing Address - Country:US
Mailing Address - Phone:845-357-0166
Mailing Address - Fax:845-357-0249
Practice Address - Street 1:2 EXECUTIVE BLVD
Practice Address - Street 2:STE 203
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901
Practice Address - Country:US
Practice Address - Phone:845-357-0166
Practice Address - Fax:845-357-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000117 1133N00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
03P091Medicare ID - Type Unspecified