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1982706446

NPI Code Detail

MEDICARE: DR. ALAN R SANDBERG MD

MEDICARE: DR. ALAN R SANDBERG MD

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	207RI0008X	Hepatology Physician	158140	NY
2	207RG0100X	Gastroenterology Physician	158140	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	76617	OTHER	NY	VYTRA SPECIALITY GI
2	03E451	OTHER	NY	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	500936	OTHER	NY	USHC SPECALITY GI
5	AP817	OTHER	NY	OXFORD
6	12423P	OTHER	NY	HIP
7	41418	OTHER	NY	VYTRA
8	470563	OTHER	NY	USHC INTERNAL MED

General Provider Information

NPI Number	:	1982706446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN R SANDBERG MD

Provider Business Mailing Address
First Line	:	162 LENOX RD
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-4041
Country	:	US
Telephone Number	:	516-404-0829
Fax Number	:	516-466-7828

Provider Business Practice Location Address
First Line	:	915 HILLSIDE AVE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-2529
Country	:	US
Telephone Number	:	347-236-3163
Fax Number	:

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

Provider Enumeration Date	:	09/03/2006
Last Update Date	:	03/17/2018

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Directions to “ DR. ALAN R SANDBERG MD” Practice Location

Language	Start Address	Practice Location

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