Provider Demographics
NPI:1700944352
Name:SACHER-GOLDSTEIN, AMY (DO)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SACHER-GOLDSTEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4908
Mailing Address - Country:US
Mailing Address - Phone:516-541-9700
Mailing Address - Fax:516-798-1086
Practice Address - Street 1:99 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-4908
Practice Address - Country:US
Practice Address - Phone:516-541-9700
Practice Address - Fax:516-798-1086
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I46574Medicare UPIN
NY3263P1Medicare ID - Type Unspecified