Provider Demographics
NPI:1104081926
Name:SACKS, ALEXANDRA CARLY (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:CARLY
Last Name:SACKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6029
Mailing Address - Country:US
Mailing Address - Phone:914-629-3340
Mailing Address - Fax:
Practice Address - Street 1:230 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6029
Practice Address - Country:US
Practice Address - Phone:914-629-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2557502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry