Provider Demographics
NPI:1891163937
Name:SANFORD MEDICAL CARE, PLLC
Entity Type:Organization
Organization Name:SANFORD MEDICAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHE-NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-461-9779
Mailing Address - Street 1:13347 SANFORD AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5800
Mailing Address - Country:US
Mailing Address - Phone:718-461-9779
Mailing Address - Fax:
Practice Address - Street 1:13347 SANFORD AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5800
Practice Address - Country:US
Practice Address - Phone:718-461-9779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-07
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty