Healthcare Provider Details

I. General information

NPI: 1952340523
Provider Name (Legal Business Name): ALAN M SANDERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 10/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 NEW SCOTLAND AVE
ALBANY NY
12208-2725
US

IV. Provider business mailing address

32 CARSTEAD DR
SLINGERLANDS NY
12159-9792
US

V. Phone/Fax

Practice location:
  • Phone: 518-435-0662
  • Fax: 518-435-0664
Mailing address:
  • Phone: 518-435-0662
  • Fax: 518-435-0664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number181447
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: