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General NPI Number Information
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NPI Number | 1164308912
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Entity Type | Individual
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Provider Name | ANNA ANJELICA REVILLA SANCHEZ MD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 550 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 212-263-5506
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Fax |
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Provider Business Mailing Address
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Address Line | 6266 BOOTH ST
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City | REGO PARK
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State | NY
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Zip | 11374-1562
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Country | US
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Telephone | 718-413-3175
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | P135040
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License Number State | NY
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