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Individual
DR. ERIC J SACKNOFF
Active
Individual
DR. ERIC J SACKNOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101239642
VA
208800000X
Urology Physician
MD-46056
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010281067
—
VA
05
—
1295734598
—
VA
01
—
199795
ANTHEM
VA
01
—
463937
SOUTHERN HEALTH
VA
01
—
P01081069
RAILROAD MEDICARE
VA
Enumeration date
07/19/2005
Last updated
07/09/2020
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