Provider Demographics
NPI:1891705554
Name:DREW, SCHWARTZ AND SACHS, DDS, PC
Entity Type:Organization
Organization Name:DREW, SCHWARTZ AND SACHS, DDS, PC
Other - Org Name:NY CENTER ORAL ORTHOGNATHIC & MAXILLOFACIAL SURGERY
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:631-376-1560
Mailing Address - Street 1:474 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4405
Mailing Address - Country:US
Mailing Address - Phone:631-376-1560
Mailing Address - Fax:631-376-1561
Practice Address - Street 1:474 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4405
Practice Address - Country:US
Practice Address - Phone:631-376-1560
Practice Address - Fax:631-376-1561
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHEN A. SACHS, DDS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-08
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028490204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01335919Medicaid
NY01145546Medicaid
NY02238062Medicaid
NY02238062Medicaid
NYD99311Medicare ID - Type UnspecifiedSAS
NY01145546Medicaid