Provider Demographics
NPI:1770111320
Name:SANCHEZ, ADRIAN A (AGNP)
Entity type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:A
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SPRINGBROOK RD E
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9162
Mailing Address - Country:US
Mailing Address - Phone:201-566-5014
Mailing Address - Fax:
Practice Address - Street 1:28 SPRINGBROOK RD E
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9162
Practice Address - Country:US
Practice Address - Phone:201-566-5014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01024100363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology