MEDICARE: DR. STEPHEN ALAN SANDS PSY.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
1	103TC2200X	Clinical Child & Adolescent Psychologist	013296	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1548233604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN ALAN SANDS PSY.D.

Provider Business Mailing Address
First Line	:	450 E 63RD ST
Second Line	:	APARTMENT 5N
City	:	NEW YORK
State	:	NY
Zip	:	10065-7928
Country	:	US
Telephone Number	:	917-435-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 LEXINGTON AVE
Second Line	:	MEMORIAL SLOAN KETTERING CANCER CENTER
City	:	NEW YORK
State	:	NY
Zip	:	10022-4503
Country	:	US
Telephone Number	:	646-888-0023
Fax Number	:	646-888-0160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	09/02/2016

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