Provider Demographics
NPI:1295962264
Name:SACKNOFF, ALBERT E (MD)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:E
Last Name:SACKNOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 SAGAMORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PLANVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1524
Mailing Address - Country:US
Mailing Address - Phone:516-367-1654
Mailing Address - Fax:516-367-1654
Practice Address - Street 1:134 SAGAMORE DRIVE
Practice Address - Street 2:
Practice Address - City:PLANVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1524
Practice Address - Country:US
Practice Address - Phone:516-367-1654
Practice Address - Fax:516-367-1654
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY085666207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine