Provider Demographics
NPI:1407570443
Name:SANCHEZ SANCHEZ, GENESIS AMANDA
Entity Type:Individual
Prefix:
First Name:GENESIS
Middle Name:AMANDA
Last Name:SANCHEZ 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:CALLE POLARIS FP-15, IRLANDA HEIGHTS
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-217-4899
Mailing Address - Fax:
Practice Address - Street 1:CALLE POLARIS FP-15
Practice Address - Street 2:IRLANDA HEIGHTS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-217-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program