1780865105 NPI number — SILVIA R. VON SACKEN, PLLC

Table of content: (NPI 1780865105)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780865105 NPI number — SILVIA R. VON SACKEN, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SILVIA R. VON SACKEN, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1780865105
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 MARY E CLARK DR STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMPSTEAD
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03841-2288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-329-6330
Provider Business Mailing Address Fax Number:
603-329-5197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 MARY E CLARK DR STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMPSTEAD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03841-2288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-329-6330
Provider Business Practice Location Address Fax Number:
603-329-5197
Provider Enumeration Date:
11/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VON SACKEN
Authorized Official First Name:
SILVIA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
LICSW
Authorized Official Telephone Number:
603-329-6330

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  1020 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3077779 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com