Provider Demographics
NPI:1861576613
Name:SACCHETTI, TINA (DC)
Entity type:Individual
Prefix:DR
First Name:TINA
Middle Name:
Last Name:SACCHETTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:THORNWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10594-1415
Mailing Address - Country:US
Mailing Address - Phone:914-747-9200
Mailing Address - Fax:914-747-4406
Practice Address - Street 1:879 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:THORNWOOD
Practice Address - State:NY
Practice Address - Zip Code:10594-1415
Practice Address - Country:US
Practice Address - Phone:914-747-9200
Practice Address - Fax:914-747-4406
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXOO4751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13-4043228OtherAETNA
NY320281OtherASH
NYP452303OtherOXFORD
NY13-4043228OtherTAX ID #
NY350044841OtherRR MEDICARE
NY13-4043228OtherUHC
NYC3000366OtherINDEPENDENT HEALTH
NY6228347-002OtherCIGNA
NYCO47516OtherWORKER'S COMP
NY320281OtherASH
NYXFWPS1Medicare PIN