Healthcare Provider Details

I. General information

NPI: 1386806966
Provider Name (Legal Business Name): LAURA D SANDER M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1259 BEDFORD AVE
BROOKLYN NY
11216-1813
US

IV. Provider business mailing address

495 FLATBUSH AVE STE C5
BROOKLYN NY
11225-3782
US

V. Phone/Fax

Practice location:
  • Phone: 800-336-1100
  • Fax:
Mailing address:
  • Phone: 833-904-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number316137
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA11719100
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD72551
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number316137
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD045055
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: