Provider Demographics
NPI:1295710408
Name:SACHS, CYNTHIA HALL (NP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:HALL
Last Name:SACHS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-595-2000
Mailing Address - Fax:508-853-7149
Practice Address - Street 1:630 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2038
Practice Address - Country:US
Practice Address - Phone:508-595-2000
Practice Address - Fax:508-853-7149
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA127851363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
0701173OtherMEDICAID WELFARE
MA0701173Medicaid
78563OtherCHILDRENS MEDICAL SECURIT
NP4770OtherBLUE SHIELD HMO BLUE
NP4770OtherMEDICARE B
042472266OtherTHREE RIVERS
042472266OtherTRICARE CHAMPUS
NP4770OtherBLUE CARE ELECT
NP4770OtherBLUE SHIELD INDEMNITY
042472266OtherPRIVATE HEALTHCARE SYSTEM
AA17880OtherHARVARD PILGRIM HEALTHCAR
78563OtherHEALTHY START
MANP4770Medicare ID - Type Unspecified
MA0701173Medicaid