Provider Demographics
NPI:1760539340
Name:GEORGE, SANDY MANCHERY (NP)
Entity Type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:MANCHERY
Last Name:GEORGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:SANDY
Other - Middle Name:M
Other - Last Name:MANCHERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:100 WOODS RD
Mailing Address - Street 2:WESTCHESTER MEDICAL CENTER 4N
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:WESTCHESTER MEDICAL CENTER 4N
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-7302
Practice Address - Fax:914-493-5045
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303748363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0803G1Medicare ID - Type Unspecified
NYQ27624Medicare UPIN