Provider Demographics
NPI:1891195780
Name:SACHER, ELYSE
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:SACHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 ELAINE DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5708
Mailing Address - Country:US
Mailing Address - Phone:516-697-4357
Mailing Address - Fax:
Practice Address - Street 1:97 ELAINE DR
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-5708
Practice Address - Country:US
Practice Address - Phone:516-607-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY432828921174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist