Individual
DR. ANDREA L SACKNOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 WEST CARVER ST, HUNTINGTON, NY 11743
(631) 421-0020
(631) 421-5991
Mailing address
200 WEST CARVER ST, HUNTINGTON, NY 11743
(631) 421-0020
(631) 421-5991
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
1797661
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00110970
RRMC
—
05
—
01608740
—
NY
01
—
112234962
TAX ID
—
01
—
1183411
UNITED
—
01
—
179766
MEDICAL LICENSE NUMBER
—
01
—
1797661
STATE LICENSE #
—
01
—
2611409
AETNA
—
01
—
394971
CONNECTICARE
—
01
—
3C1456
HEALTHNET
—
01
—
74976
VYTRA
—
01
—
AS03V12910
BLUE CROSS BLUE SHIELD
—
01
—
P2069468
OXFORD
—
01
—
PP50275
MDNY
—
Enumeration date
08/31/2006
Last updated
03/07/2023
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