Provider Demographics
NPI:1417017674
Name:DAVID J. SANDS, DPM, PC
Entity Type:Organization
Organization Name:DAVID J. SANDS, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-482-8826
Mailing Address - Street 1:560 NORTHERN BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5100
Mailing Address - Country:US
Mailing Address - Phone:516-482-8826
Mailing Address - Fax:516-482-8828
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5100
Practice Address - Country:US
Practice Address - Phone:516-482-8826
Practice Address - Fax:516-482-8828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005419213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00417949OtherRAILROAD MEDICARE
NY01978005Medicaid
NY07892GOtherGHI MEDICARE
NYPB0241OtherEMPIRE MEDICARE
NYPB0241OtherEMPIRE MEDICARE
NYP00417949OtherRAILROAD MEDICARE