Healthcare Provider Details

I. General information

NPI: 1740216829
Provider Name (Legal Business Name): KENNETH SAX F.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 MAIN ST HUDSON RIVER HEALTHCARE, INC.
PEEKSKILL NY
10566-2913
US

IV. Provider business mailing address

1037 MAIN ST HUDSON RIVER HEALTHCARE, INC.
PEEKSKILL NY
10566-2913
US

V. Phone/Fax

Practice location:
  • Phone: 914-734-8800
  • Fax: 914-734-8808
Mailing address:
  • Phone: 914-734-8800
  • Fax: 914-734-8786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF331220
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: