Healthcare Provider Details

I. General information

NPI: 1104828193
Provider Name (Legal Business Name): AMR AHMAD MUHAMMED EL SANDOUBY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AMR A SANDUBY MD

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3432 E TREMONT AVE FRNT 5
BRONX NY
10465-2033
US

IV. Provider business mailing address

3432 E TREMONT AVE FRNT 5
BRONX NY
10465-2033
US

V. Phone/Fax

Practice location:
  • Phone: 917-578-7376
  • Fax: 718-822-7400
Mailing address:
  • Phone: 917-578-7376
  • Fax: 718-822-7400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number219265
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number219265
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: