Provider Demographics
NPI:1669641379
Name:SACHS, LARISSA V (MD)
Entity Type:Individual
Prefix:
First Name:LARISSA
Middle Name:V
Last Name:SACHS
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 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 WALNUT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1168
Practice Address - Country:US
Practice Address - Phone:717-761-4141
Practice Address - Fax:717-703-0121
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD436970207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
002124191OtherHIGHMARK BLUE SHIELD
PA102377980Medicaid
PA167609Medicare PIN