Provider Demographics
NPI:1558413492
Name:SACHAROK, CYNTHIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:SACHAROK
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 1:500 MACDADE BLVD
Mailing Address - Street 2:
Mailing Address - City:MILMONT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19033-3311
Mailing Address - Country:US
Mailing Address - Phone:610-619-7300
Mailing Address - Fax:610-522-0445
Practice Address - Street 1:500 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:MILMONT PARK
Practice Address - State:PA
Practice Address - Zip Code:19033
Practice Address - Country:US
Practice Address - Phone:610-619-7300
Practice Address - Fax:610-522-0445
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043214L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA011229775Medicaid
PA011229775Medicaid
PAE87183Medicare UPIN