MEDICARE: DR. BRIAN SAKS PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	022004	NY

General Provider Information

NPI Number	:	1245597061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN SAKS PSY.D.

Provider Business Mailing Address
First Line	:	75 PROSPECT ST
Second Line	:	STE 114
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-3310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 PROSPECT ST
Second Line	:	STE 114
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-3310
Country	:	US
Telephone Number	:	415-418-7257
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	02/23/2017

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