Provider Demographics
NPI:1447428057
Name:SACKS, THOMAS S (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:S
Last Name:SACKS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 OAK RD
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-1366
Mailing Address - Country:US
Mailing Address - Phone:973-601-7797
Mailing Address - Fax:
Practice Address - Street 1:5774 BERKSHIRE VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07438-9847
Practice Address - Country:US
Practice Address - Phone:973-208-2255
Practice Address - Fax:973-208-2194
Is Sole Proprietor?:No
Enumeration Date:2008-02-16
Last Update Date:2008-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01701800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI01701800OtherRPH STATE LICENSE NUMBER