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NPI Code Detail

MEDICARE: DR. AMR A. EL SANDUBY M.D.

MEDICARE:  DR. AMR A. EL SANDUBY  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician219265NY
2208VP0000XPain Medicine Physician219265NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104828193
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMR A. EL SANDUBY M.D.
Provider Business Mailing Address
First Line : 3432 E TREMONT AVE FRNT 5
Second Line :
City : BRONX
State : NY
Zip : 10465-2033
Country : US
Telephone Number : 917-578-7376
Fax Number : 718-822-7400
Provider Business Practice Location Address
First Line : 3432 E TREMONT AVE FRNT 5
Second Line :
City : BRONX
State : NY
Zip : 10465-2033
Country : US
Telephone Number : 917-578-7376
Fax Number : 718-822-7400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 08/02/2013

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