Healthcare Provider Details

I. General information

NPI: 1780640284
Provider Name (Legal Business Name): VICTOR A SACCHI JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 CORPORATE WOODS STE 200C
ROCHESTER NY
14623
US

IV. Provider business mailing address

135 CORPORATE WOODS STE 200C
ROCHESTER NY
14623-1459
US

V. Phone/Fax

Practice location:
  • Phone: 585-784-7848
  • Fax: 585-784-7844
Mailing address:
  • Phone: 585-784-7848
  • Fax: 585-784-7844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number133999
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number133999
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: