Healthcare Provider Details

I. General information

NPI: 1326041021
Provider Name (Legal Business Name): SANFORD S. ZEVON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 DAVIS AVE
WHITE PLAINS NY
10605-1030
US

IV. Provider business mailing address

210 WESTCHESTER AVE
WHITE PLAINS NY
10604-2901
US

V. Phone/Fax

Practice location:
  • Phone: 914-948-3630
  • Fax: 914-946-0926
Mailing address:
  • Phone: 914-681-3110
  • Fax: 914-682-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number82781
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: