1750340121 NPI number — ISAAC SACHMECHI MD

Table of content: ISAAC SACHMECHI MD (NPI 1750340121)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750340121 NPI number — ISAAC SACHMECHI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SACHMECHI
Provider First Name:
ISAAC
Provider Middle Name:
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:
1750340121
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3003 NEW HYDE PARK RD
Provider Second Line Business Mailing Address:
201
Provider Business Mailing Address City Name:
NEW HYDE PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11042-1214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-327-0850
Provider Business Mailing Address Fax Number:
516-327-0920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3003 NEW HYDE PARK RD
Provider Second Line Business Practice Location Address:
201
Provider Business Practice Location Address City Name:
NEW HYDE PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11042-1214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-327-0850
Provider Business Practice Location Address Fax Number:
516-327-0920
Provider Enumeration Date:
03/22/2006

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: 207RE0101X , with the licence number:  163151-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0106315NY01 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0436009004 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112552030 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: N24263 . This is a "GUARDIAN PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42728V . This is a "VYTRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 91042 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: AS1660 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000815 . This is a "COMBINED WELFARE FUND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000815 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 110171970 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 81D151 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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