Provider Demographics
NPI:1639198518
Name:SAND, BILLY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:
Last Name:SAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:718-613-4471
Mailing Address - Fax:718-631-4381
Practice Address - Street 1:350 LEFFERTS AVE
Practice Address - Street 2:1D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4348
Practice Address - Country:US
Practice Address - Phone:917-613-9920
Practice Address - Fax:718-613-4381
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014110-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist