Provider Demographics
NPI:1154656544
Name:SANDAR, MA (MD)
Entity Type:Individual
Prefix:DR
First Name:MA
Middle Name:
Last Name:SANDAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 W 110TH ST
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2086
Mailing Address - Country:US
Mailing Address - Phone:212-864-8888
Mailing Address - Fax:212-864-8928
Practice Address - Street 1:535 W 110TH ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2086
Practice Address - Country:US
Practice Address - Phone:212-864-8888
Practice Address - Fax:212-864-8928
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254965207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine