Provider Demographics
NPI:1992199012
Name:SANCHEZ, RAUL DAVON
Entity Type:Individual
Prefix:
First Name:RAUL
Middle Name:DAVON
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 FORT WASHINGTON AVE APT 111
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6822
Mailing Address - Country:US
Mailing Address - Phone:646-573-9878
Mailing Address - Fax:202-600-7618
Practice Address - Street 1:370 FORT WASHINGTON AVE APT 111
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6822
Practice Address - Country:US
Practice Address - Phone:646-573-9878
Practice Address - Fax:202-600-7618
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No171M00000XOther Service ProvidersCase Manager/Care Coordinator