Healthcare Provider Details

I. General information

NPI: 1184603227
Provider Name (Legal Business Name): LEONARD L SANDLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 BEAVERSON BLVD STE 8C
BRICK NJ
08723-7861
US

IV. Provider business mailing address

35 BEAVERSON BLVD STE 8C
BRICK NJ
08723-7861
US

V. Phone/Fax

Practice location:
  • Phone: 732-262-4262
  • Fax: 732-262-4319
Mailing address:
  • Phone: 732-262-4262
  • Fax: 732-262-4317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberMA07733800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA07733800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: