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General NPI Number Information
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NPI Number | 1205172640
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Entity Type | Individual
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Provider Name | JOSEPH SACKS L.M.S.W.
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Gender | Male
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Dates
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Enumeration Date | 12/12/2012
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 521 W 239TH ST
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City | BRONX
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State | NY
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Zip | 10463-1205
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Country | US
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Telephone | 718-601-2280
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Fax |
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Provider Business Mailing Address
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Address Line | 40 HARRISON ST 6L
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City | NEW YORK
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State | NY
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Zip | 10013-2742
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Country | US
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Telephone | 646-528-2528
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 087297
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License Number State | NY
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