Provider Demographics
NPI:1609966076
Name:WHITE, SANFORD F (MD)
Entity Type:Individual
Prefix:MR
First Name:SANFORD
Middle Name:F
Last Name:WHITE
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:PO BOX 70
Mailing Address - Street 2:C/O THE SOMERSET NETWORK
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07091
Mailing Address - Country:US
Mailing Address - Phone:908-317-6807
Mailing Address - Fax:908-317-6896
Practice Address - Street 1:B4 CORNWALL CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3352
Practice Address - Country:US
Practice Address - Phone:732-698-7966
Practice Address - Fax:732-698-7366
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04008400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD06340Medicare UPIN
NJ406544Medicare ID - Type Unspecified