Provider Demographics
NPI:1386941573
Name:SACHAKOV, CHRISTINE (MHNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SACHAKOV
Suffix:
Gender:F
Credentials:MHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BUCKLEY ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-1704
Mailing Address - Country:US
Mailing Address - Phone:845-747-5600
Mailing Address - Fax:845-747-5700
Practice Address - Street 1:17 BUCKLEY ST UNIT 2
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-1704
Practice Address - Country:US
Practice Address - Phone:845-747-5600
Practice Address - Fax:845-747-5700
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401253363LP0808X
NYF401253-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health