Provider Demographics
NPI:1437134194
Name:SACHS, ROBERT M (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:SACHS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 S SALINA ST
Mailing Address - Street 2:STE 355
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2405
Mailing Address - Country:US
Mailing Address - Phone:315-422-6088
Mailing Address - Fax:315-422-0078
Practice Address - Street 1:441 S SALINA ST
Practice Address - Street 2:STE 355
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2405
Practice Address - Country:US
Practice Address - Phone:315-422-6088
Practice Address - Fax:315-422-0078
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS TUV267001152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000911314001OtherHEALTH NOW
NY00449770Medicaid
595204OtherMVP
NY00449770Medicaid
000911314001OtherHEALTH NOW