Provider Demographics
NPI:1336105782
Name:SAND, NEIL L (DO)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:L
Last Name:SAND
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:8200 FLOURTOWN AVE
Mailing Address - Street 2:STE 7
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038
Mailing Address - Country:US
Mailing Address - Phone:215-836-5100
Mailing Address - Fax:215-836-6011
Practice Address - Street 1:8200 FLOURTOWN AVE
Practice Address - Street 2:STE 7
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038
Practice Address - Country:US
Practice Address - Phone:215-836-5100
Practice Address - Fax:215-836-6011
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2010-06-29
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Provider Licenses
StateLicense IDTaxonomies
PAOS 006473 E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E27374Medicare UPIN