Provider Demographics
NPI:1720130867
Name:SANON, L. PAUL ANTOINE (MD)
Entity Type:Individual
Prefix:DR
First Name:L. PAUL
Middle Name:ANTOINE
Last Name:SANON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86-15 MARENGO STREET
Mailing Address - Street 2:
Mailing Address - City:HOLLISWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1325
Mailing Address - Country:US
Mailing Address - Phone:718-468-8248
Mailing Address - Fax:718-776-8055
Practice Address - Street 1:211 CENTRAL PARK W STE 1K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6020
Practice Address - Country:US
Practice Address - Phone:212-362-4818
Practice Address - Fax:718-776-8055
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1961312084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY508369OtherVALUEOPTIONS
NY396BU1OtherEBCBS
NY7340751OtherGHI
NY230978POtherHIP
NY1627742OtherCIGNA HEALTH CARE
NYP3181732OtherOXFORD HEALTH PLAN
NY7899610OtherAETNA HEALTH CARE
NY230976POtherHIP
NY69J501Medicare ID - Type Unspecified
NYF94851Medicare UPIN