Provider Demographics
NPI:1932430063
Name:SACHS, SUSAN BAKEWELL (PHD, CRNP)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:BAKEWELL
Last Name:SACHS
Suffix:
Gender:F
Credentials:PHD, CRNP
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:BAKEWELL-SACHS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, CRNP
Mailing Address - Street 1:7 ROSEDALE WAY
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-9740
Mailing Address - Country:US
Mailing Address - Phone:609-203-0599
Mailing Address - Fax:
Practice Address - Street 1:3550 MARKET ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3329
Practice Address - Country:US
Practice Address - Phone:215-590-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN236614L163WP0200X
PASP003919N364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics