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General NPI Number Information
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NPI Number | 1194830356
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Entity Type | Individual
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Provider Name | SANDY L IMPERIAL MD
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 169 MARTIN AVE
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City | EPHRATA
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State | PA
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Zip | 17522-1734
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Country | US
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Telephone | 717-738-6408
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Fax | 717-738-6533
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-738-6114
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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 | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | MD061705L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | MD061705L
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License Number State | PA
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