Provider Demographics
NPI:1881020386
Name:SACK, VIRGINIA L (MS)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:L
Last Name:SACK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 NEW SCOTLAND AVE
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3555
Mailing Address - Country:US
Mailing Address - Phone:518-264-1064
Mailing Address - Fax:518-264-1065
Practice Address - Street 1:16 NEW SCOTLAND AVE
Practice Address - Street 2:FLOOR 2
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3555
Practice Address - Country:US
Practice Address - Phone:518-264-1064
Practice Address - Fax:518-264-1065
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS