Provider Demographics
NPI:1588649362
Name:SACKS, RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:SACKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 HOOPER AVE
Mailing Address - Street 2:SUTIE B
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-1600
Mailing Address - Country:US
Mailing Address - Phone:732-864-0111
Mailing Address - Fax:732-864-0122
Practice Address - Street 1:1901 HOOPER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-1600
Practice Address - Country:US
Practice Address - Phone:732-864-0111
Practice Address - Fax:732-864-0122
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA27524207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery