Provider Demographics
NPI:1124310834
Name:SACKS, HARRY JACK (MD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:JACK
Last Name:SACKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3186 AQUETONG RD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-9404
Mailing Address - Country:US
Mailing Address - Phone:732-648-9459
Mailing Address - Fax:
Practice Address - Street 1:3186 AQUETONG RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-9404
Practice Address - Country:US
Practice Address - Phone:732-648-9459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07839600208000000X, 208VP0000X
PAMD040172E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD040172EOtherPA BOARD OF MEDICAL EXAMINERS