DR. DAVID M SACK (NPI# 1710986898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710986898 |
| Entity Type | Individual |
| Full Name | DR. DAVID M SACK |
| Credential | M.D. |
| Practice Address |
455 Lewis Ave Suite 105 Meriden CT 06451-2121 |
| Practice Telephone | 2032372477 |
| Practice Fax Number | 2032381839 |
| Mailing Telephone | 2032372477 |
| Mailing Fax Number | 2032381839 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
027392 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1273929 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558331256 | David Michael Sack | Preventive Medicine | 6632 Indian River Rd, Virginia Beach, VA 23464-3442 | 2006-01-25 |
| 1467657882 | David Andrew Sack | Psychiatry & Neurology | 19456 Woodlands Ln, Huntington Beach, CA 92648-5570 | 2007-06-16 |
| 1568416725 | David I Sack | Emergency Medicine | 620 Shadow Ln, Las Vegas, NV 89106-4119 | 2006-05-20 |
| Street Address |
455 LEWIS AVE SUITE 105 |
| City | MERIDEN |
| State | CT |
| Zip Code | 06451-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740601665 | Katelyn Spence | Nurse Practitioner | 455 Lewis Ave, Suite 220, Meriden, CT 06451-2121 | 2013-12-18 |
| 1336491752 | Hartford Healthcare Medical Group, Inc | Urology | 455 Lewis Ave, Ste. 210, Meriden, CT 06451-2121 | 2012-10-09 |
| 1316227291 | Hartford Clinical Associates, PC | Urology | 455 Lewis Ave, Suite 210, Meriden, CT 06451-2121 | 2011-08-23 |
| 1265669089 | Madhavi Bhoomagoud | Internal Medicine | 455 Lewis Ave, Suite 105, Meriden, CT 06451-2121 | 2009-06-18 |
| 1982839247 | Connecticut Nephrology Associates LLC | Internal Medicine | 455 Lewis Ave, Suite 214, Meriden, CT 06451-2121 | 2009-05-15 |
| 1639316177 | Rafal Barczak | Surgery | 455 Lewis Ave, Meriden, CT 06451-2121 | 2009-01-20 |
| 1598919045 | Paul Pyo | Urology | 455 Lewis Ave, Suite 210, Meriden, CT 06451-2121 | 2008-11-11 |
| 1962654178 | Bluegrass Medicine & Nephrology, LLC | Clinic/Center | 455 Lewis Ave, Suite 214, Meriden, CT 06451-2121 | 2008-10-21 |
| 1366692691 | Aly Hemdan Abdalla | Internal Medicine | 455 Lewis Ave, Suite 206, Meriden, CT 06451-2121 | 2008-09-23 |
| 1164606372 | Kenneth M Schwartz | Surgery | 455 Lewis Ave, Suite 208, Meriden, CT 06451-2121 | 2007-12-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225490055 | Great Hills LLC | Pharmacy | 152 Colony St Unit A, Meriden, CT 06451 | 2016-03-22 |
| 1659695344 | Dr. Bertolli Od & Associates LLC | Optometrist | 470 Lewis Avenue, C/o Sears Optical, Meriden, CT 06451 | 2010-03-24 |
| 1205086733 | Michelle Lavallee Dagostine | Psychiatry & Neurology | 455 Lewis Ave., Suite 221, Meriden, CT 06451 | 2008-09-20 |
| 1538212857 | Meriden Surgical Supply Inc | Prosthetic/Orthotic Supplier | 170 West Main Street, Meriden, CT 06451 | 2007-01-19 |
| 1922036920 | Lisa M Marvin Smith | Nurse Practitioner | 26 Womens Way, Meriden, CT 06451 | 2006-06-29 |
| 1831683523 | Trisha Kowalski | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-06-18 |
| 1093203424 | Ryan Wessels | Physician Assistant | 435 Lewis Ave, Meriden, CT 06451 | 2018-05-01 |
| 1235599333 | Mcm Dental, LLC | Dentist | 74 Main Street, Lakewood, CT 06451 | 2016-03-02 |
| 1215270533 | Rouzbeh Fateh | Psychiatry & Neurology | 435 Lewis Ave, Meriden, CT 06451 | 2013-04-04 |
| 1790035186 | Jona Lesage Maloney | Music Therapist | 122 Windsor Ave, 2nd Floor, Meriden, CT 06451 | 2012-09-13 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598893224 | Jonathan A. White | Internal Medicine | 455 Lewis Ave, Suite 106, Meriden, CT 06451-2121 | 2007-03-02 |
| 1003823683 | Kevin Jo | Internal Medicine | 455 Lewis Ave, Suite 106, Meriden, CT 06451-2121 | 2006-08-03 |
| 1487677951 | Midstate Gastroenterology Specialists PC | Internal Medicine | 455 Lewis Ave, Suite 105, Meriden, CT 06451-2121 | 2006-07-25 |
| 1942295449 | Janet B Dickinson | Internal Medicine | 199 W Main St, Meriden, CT 06451-4024 | 2005-09-12 |
| 1629077714 | Housein M Wazaz | Internal Medicine | 455 Lewis Ave, Suite 105, Meriden, CT 06451-2121 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730525734 | Benjamin Barbash | Internal Medicine | 888 White Plains Rd Ste 110, Trumbull, CT 06611-4552 | 2013-05-16 |
| 1144665969 | Brian Thomas Moy | Internal Medicine | 2400 Tamarack Ave Ste 101, South Windsor, CT 06074 | 2013-05-07 |
| 1598109753 | Radhika Naga Ayyagari | Internal Medicine | Prime Healthcare PC, 44 Dale Rd, Avon, CT 06001-4320 | 2013-04-18 |
| 1205279247 | Jared Macklin | Internal Medicine | 800 Boston Post Rd Ste 201, Guilford, CT 06437 | 2013-04-09 |
| 1316209141 | Jenna Koliani-pace | Internal Medicine | 300 Western Blvd Ste A, Glastonbury, CT 06033-4305 | 2012-06-07 |
| 1891055323 | Martin H. Floch,m.d.pc | Internal Medicine | 32 Woody Ln, Westport, CT 06880-2259 | 2012-05-17 |
| 1720396567 | Breiter Tech Corp | Internal Medicine | 2842 Main St, Ste 309, Glastonbury, CT 06033-1077 | 2010-09-14 |
| 1275775058 | Donald E. Gullickson IIi | Internal Medicine | Uconn Health Center 263 Farmington Ave, Farmington, CT 06030-0001 | 2009-03-25 |
| 1356582571 | Miechelle L. O'brien | Internal Medicine | 111 Osborne Street- Ste 121, Danbury, CT 06810-6019 | 2009-03-18 |
| 1962656314 | Jefrey Salek | Internal Medicine | 79 Wawecus St., Suite 101, Norwich, CT 06360-2173 | 2008-11-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.