Provider Demographics
NPI:1427379072
Name:B. SAND, PSYCHOLOGIST P.C.
Entity Type:Organization
Organization Name:B. SAND, PSYCHOLOGIST P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:347-405-8130
Mailing Address - Street 1:725 166TH ST
Mailing Address - Street 2:#4C
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2061
Mailing Address - Country:US
Mailing Address - Phone:347-405-8130
Mailing Address - Fax:347-405-8131
Practice Address - Street 1:725 166TH ST
Practice Address - Street 2:#4C
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-2061
Practice Address - Country:US
Practice Address - Phone:347-405-8130
Practice Address - Fax:347-405-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014110-1261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02785317Medicaid