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1801944962 NPI number — PETER G SACK M.D.

NPI Number: 1801944962
Health Care Provider/Practitioner: PETER G SACK M.D.

Information about “1801944962” NPI (PETER G SACK M.D.) exists in 1801944962 in HTML format HTML  |  1801944962 in plain Text format TXT  |  1801944962 in PDF (Portable Document Format) PDF  |  1801944962 in an XML format XML  formats.

NPI Number : 1801944962 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1801944962",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SACK",
    "FirstName": "PETER",
    "MiddleName": "G",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3333 HENRY HUDSON PKWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRONX",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10463-3224",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-884-6400",
    "MailingAddressFaxNumber": "718-796-0210",
    "FirstLinePracticeLocationAddress": "3333 HENRY HUDSON PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRONX",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10463-3224",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "718-884-6400",
    "PracticeLocationAddressFaxNumber": "718-796-0210",
    "EnumerationDate": "01/08/2007",
    "LastUpdateDate": "09/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "106810",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0805X",
          "TaxonomyName": "Geriatric Psychiatry Physician",
          "LicenseNumber": "106810",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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