Provider Demographics
NPI:1134894546
Name:SACKS SLP P.C.
Entity type:Organization
Organization Name:SACKS SLP P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TZIPORA
Authorized Official - Middle Name:
Authorized Official - Last Name:SACKS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP, TSHH
Authorized Official - Phone:917-848-7569
Mailing Address - Street 1:723 E PARK CT
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3507
Mailing Address - Country:US
Mailing Address - Phone:917-848-7569
Mailing Address - Fax:
Practice Address - Street 1:723 E PARK CT
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-3507
Practice Address - Country:US
Practice Address - Phone:917-848-7569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty