Provider Demographics
NPI:1982092185
Name:SANCHEZ, JOHN MARSHALL (LPN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MARSHALL
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 FELLER DR
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-1209
Mailing Address - Country:US
Mailing Address - Phone:914-439-6044
Mailing Address - Fax:
Practice Address - Street 1:17 FELLER DR
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-1209
Practice Address - Country:US
Practice Address - Phone:914-439-6044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263723164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse