Provider Demographics
NPI:1356439632
Name:SANCHEZ, CONCEPCION
Entity Type:Individual
Prefix:MS
First Name:CONCEPCION
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1566 LONGFELLOW AVE
Mailing Address - Street 2:PRIVATE HOUSE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-5604
Mailing Address - Country:US
Mailing Address - Phone:917-324-9776
Mailing Address - Fax:718-828-1318
Practice Address - Street 1:1566 LONGFELLOW AVE
Practice Address - Street 2:PRIVATE HOUSE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-5604
Practice Address - Country:US
Practice Address - Phone:917-324-9776
Practice Address - Fax:718-828-1318
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN/A171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator