Healthcare Provider Details

I. General information

NPI: 1669641379
Provider Name (Legal Business Name): LARISSA V SACHS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WALNUT ST SUITE 100
LEMOYNE PA
17043-1168
US

IV. Provider business mailing address

409 S 2ND ST SUITE 2F
HARRISBURG PA
17104-1612
US

V. Phone/Fax

Practice location:
  • Phone: 717-761-4141
  • Fax: 717-703-0121
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD436970
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: