1467795195 NPI number — AARON NORMAN SACHS MD

Table of content: AARON NORMAN SACHS MD (NPI 1467795195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467795195 NPI number — AARON NORMAN SACHS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SACHS
Provider First Name:
AARON
Provider Middle Name:
NORMAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467795195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 748613
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-8613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15195 HEATHCOTE BLVD STE 330
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAYMARKET
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20169-6244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-284-3440
Provider Business Practice Location Address Fax Number:
571-284-3459
Provider Enumeration Date:
04/01/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MD468394 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 0101275680 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 103299421 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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