Provider Demographics
NPI:1477723021
Name:SETH W. SACHS MD
Entity Type:Organization
Organization Name:SETH W. SACHS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-712-5501
Mailing Address - Street 1:405 ROCHELLE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3341
Mailing Address - Country:US
Mailing Address - Phone:201-712-5501
Mailing Address - Fax:201-712-5505
Practice Address - Street 1:405 ROCHELLE AVE
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3341
Practice Address - Country:US
Practice Address - Phone:201-712-5501
Practice Address - Fax:201-712-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1240420001Medicare NSC