Healthcare Provider Details

I. General information

NPI: 1013579838
Provider Name (Legal Business Name): SANDY NASR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 RIVERSIDE DR
BINGHAMTON NY
13905-4176
US

IV. Provider business mailing address

6382 TULIPWOOD LN
JAMESVILLE NY
13078-8404
US

V. Phone/Fax

Practice location:
  • Phone: 607-798-1842
  • Fax:
Mailing address:
  • Phone: 315-416-5956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number327002
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: