Healthcare Provider Details

I. General information

NPI: 1992297204
Provider Name (Legal Business Name): CAMILA BUENO-SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAMILA SANCHEZ MS

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 S COUNTRY RD
EAST PATCHOGUE NY
11772
US

IV. Provider business mailing address

58 HORSEBLOCK RD APT 1B
CENTEREACH NY
11720-4349
US

V. Phone/Fax

Practice location:
  • Phone: 631-286-0343
  • Fax:
Mailing address:
  • Phone: 516-728-0176
  • Fax: 516-728-0176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: