Healthcare Provider Details

I. General information

NPI: 1538972641
Provider Name (Legal Business Name): TAKAHIRO SANADA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 08/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COMMUNITY DRIVE NEUROSURGERY PROGRAM, NORTH SHORE U
MANHASSET NY
11030
US

IV. Provider business mailing address

300 COMMUNITY DRIVE NEUROSURGERY PROGRAM, NORTH SHORE U
MANHASSET NY
11030
US

V. Phone/Fax

Practice location:
  • Phone: 516-562-4221
  • Fax: 516-562-2860
Mailing address:
  • Phone: 516-562-4221
  • Fax: 516-562-2860

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: