Healthcare Provider Details

I. General information

NPI: 1548233604
Provider Name (Legal Business Name): STEPHEN ALAN SANDS PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 LEXINGTON AVE MEMORIAL SLOAN KETTERING CANCER CENTER
NEW YORK NY
10022-4503
US

IV. Provider business mailing address

450 E 63RD ST APARTMENT 5N
NEW YORK NY
10065-7928
US

V. Phone/Fax

Practice location:
  • Phone: 646-888-0023
  • Fax: 646-888-0160
Mailing address:
  • Phone: 917-435-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number013296
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: