Provider Demographics
NPI:1104949213
Name:SACER, LOUIS WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:WILLIAM
Last Name:SACER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 N TERRY HILL RD
Mailing Address - Street 2:PO BOX 967
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-5229
Mailing Address - Country:US
Mailing Address - Phone:845-225-1000
Mailing Address - Fax:845-225-0585
Practice Address - Street 1:287 N TERRY HILL RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-5229
Practice Address - Country:US
Practice Address - Phone:845-225-1000
Practice Address - Fax:845-225-0585
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004056-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX22971Medicare ID - Type Unspecified