Provider Demographics
NPI:1699774513
Name:SAKOWSKI, JACEK (MD)
Entity type:Individual
Prefix:DR
First Name:JACEK
Middle Name:
Last Name:SAKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:117 SEBER RD
Mailing Address - Street 2:BLD 4 SUITE C
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1722
Mailing Address - Country:US
Mailing Address - Phone:908-852-8096
Mailing Address - Fax:908-852-5012
Practice Address - Street 1:4C DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1716
Practice Address - Country:US
Practice Address - Phone:908-852-8096
Practice Address - Fax:908-852-5012
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA076148002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0121193Medicaid