Provider Demographics
NPI:1952325896
Name:SACHS, TAMARA MARIANNE (MD)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:MARIANNE
Last Name:SACHS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:M
Other - Last Name:SACHS JANOWICZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15 BENNITT ST
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2730
Mailing Address - Country:US
Mailing Address - Phone:860-354-3304
Mailing Address - Fax:
Practice Address - Street 1:15 BENNITT ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2730
Practice Address - Country:US
Practice Address - Phone:860-354-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028731133N00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E33415Medicare UPIN