Provider Demographics
NPI:1639192602
Name:SAKURAI, NAO (MD)
Entity Type:Individual
Prefix:DR
First Name:NAO
Middle Name:
Last Name:SAKURAI
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 1:230 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-5144
Mailing Address - Country:US
Mailing Address - Phone:413-420-2200
Mailing Address - Fax:413-539-9535
Practice Address - Street 1:230 MAPLE ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5144
Practice Address - Country:US
Practice Address - Phone:413-420-2200
Practice Address - Fax:413-539-9535
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1300237OtherMASSHEALTH