Provider Demographics
NPI:1053616888
Name:SACHS, LORI WEISBERGER (MS/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:WEISBERGER
Last Name:SACHS
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:E
Other - Last Name:WEISBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:195 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1732
Mailing Address - Country:US
Mailing Address - Phone:516-295-7000
Mailing Address - Fax:
Practice Address - Street 1:195 BROADWAY
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1732
Practice Address - Country:US
Practice Address - Phone:516-295-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005145235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005145OtherNYS LICENSE AS A SPEECH LANGUAGE PATHOLOGIST