Provider Demographics
NPI:1396768081
Name:SACKSTEIN, ADAM (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:SACKSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MATAWAN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2653
Mailing Address - Country:US
Mailing Address - Phone:732-441-7177
Mailing Address - Fax:732-441-7165
Practice Address - Street 1:2271 HIGHWAY 33 STE 103
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1749
Practice Address - Country:US
Practice Address - Phone:609-890-4080
Practice Address - Fax:609-890-4090
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06080300208VP0000X, 208VP0014X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5565633OtherCIGNA
NH220072700OtherACS
NJ050061753Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NJ5565633OtherCIGNA
NJ050062394Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NJ529120M62Medicare ID - Type Unspecified