Provider Demographics
NPI:1821021411
Name:SACK, MARTHA JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:JANE
Last Name:SACK
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 1:1200 OLD YORK RD
Mailing Address - Street 2:ABINGTON MEMORIAL HOSPITAL
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3720
Mailing Address - Country:US
Mailing Address - Phone:215-481-2365
Mailing Address - Fax:215-481-4481
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:ABINGTON MEMORIAL HOSPITAL
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-2365
Practice Address - Fax:215-481-4481
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041523E207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA701311Medicare ID - Type Unspecified
PAF09061Medicare UPIN