Provider Demographics
NPI:1679670335
Name:SACKS-STERN, BRACHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRACHA
Middle Name:
Last Name:SACKS-STERN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2515
Mailing Address - Country:US
Mailing Address - Phone:516-538-1070
Mailing Address - Fax:516-538-7990
Practice Address - Street 1:402 LINDEN ST
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2515
Practice Address - Country:US
Practice Address - Phone:516-538-1070
Practice Address - Fax:516-538-7990
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011618103TC0700X, 103TC2200X, 103TS0200X, 103TF0000X, 103T00000X, 103TA0700X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP715091OtherOXFORD
NY142246OtherVALUE OPTIONS
NY6801940OtherGHI
NY6801940OtherGHI