Healthcare Provider Details

I. General information

NPI: 1598730178
Provider Name (Legal Business Name): ANDREW K. SANDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 W 12TH ST SPELLMAN 7
NEW YORK NY
10011-8202
US

IV. Provider business mailing address

170 W 12TH ST SPELLMAN 7
NEW YORK NY
10011-8202
US

V. Phone/Fax

Practice location:
  • Phone: 212-604-6266
  • Fax: 212-604-6287
Mailing address:
  • Phone: 212-604-6266
  • Fax: 212-604-6287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number166721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: