Provider Demographics
NPI:1548238843
Name:SANDOR, ANDRAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRAS
Middle Name:
Last Name:SANDOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MONTVALE AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3649
Mailing Address - Country:US
Mailing Address - Phone:781-418-1900
Mailing Address - Fax:781-438-3125
Practice Address - Street 1:91 MONTVALE AVE STE 208
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3649
Practice Address - Country:US
Practice Address - Phone:781-418-1900
Practice Address - Fax:781-438-3125
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221965208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2084996Medicaid
MAJ28174OtherBCBS
MAI16544Medicare UPIN
MA2084996Medicaid