Provider Demographics
NPI:1295722999
Name:SANDOVAL, CLAUDIO (MD)
Entity type:Individual
Prefix:
First Name:CLAUDIO
Middle Name:
Last Name:SANDOVAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:22 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1533
Mailing Address - Country:US
Mailing Address - Phone:914-593-1710
Mailing Address - Fax:914-593-1790
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:STE 1400
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-493-7997
Practice Address - Fax:914-594-4022
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2016-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1764572080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01422926Medicaid
NY7169604Medicaid
NYF57596Medicare UPIN
NY01422926Medicaid