1205823523 NPI number — MR. ISRAEL L SANCHEZ MD

Table of content: MR. ISRAEL L SANCHEZ MD (NPI 1205823523)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205823523 NPI number — MR. ISRAEL L SANCHEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANCHEZ
Provider First Name:
ISRAEL
Provider Middle Name:
L
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205823523
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10439
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TRENTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08650-4039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-581-5303
Provider Business Mailing Address Fax Number:
609-631-6839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2119 HIGHWAY 33
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
HAMILTON SQUARE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08690-1740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-581-5303
Provider Business Practice Location Address Fax Number:
609-631-6839
Provider Enumeration Date:
10/03/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  25MA04125100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2K2874 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 050770700 . This is a "AMERIHEALTH PRODUCTS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 050071447 . This is a "RR MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0894907 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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