Healthcare Provider Details

I. General information

NPI: 1679574537
Provider Name (Legal Business Name): JOAN W SACHS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 WOBURN ST
READING MA
01867-2907
US

IV. Provider business mailing address

8 JEFFERSON ST
MARBLEHEAD MA
01945-2310
US

V. Phone/Fax

Practice location:
  • Phone: 781-944-4250
  • Fax: 781-944-6895
Mailing address:
  • Phone: 781-990-1148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number207924
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: