MEDICARE: SETH W. SACHS MD

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	207W00000X	Ophthalmology Physician	25MA04557300	NJ

General Provider Information

NPI Number	:	1679512610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH W. SACHS MD

Provider Business Mailing Address
First Line	:	405 ROCHELLE AVE
Second Line	:
City	:	ROCHELLE PARK
State	:	NJ
Zip	:	07662-3326
Country	:	US
Telephone Number	:	201-712-5501
Fax Number	:	201-712-5505

Provider Business Practice Location Address
First Line	:	405 ROCHELLE AVE
Second Line	:
City	:	ROCHELLE PARK
State	:	NJ
Zip	:	07662-3326
Country	:	US
Telephone Number	:	201-712-5501
Fax Number	:	201-712-5505

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	12/29/2007

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