Provider Demographics
NPI:1215237581
Name:SANGSTER SADAPHAL, AUDREY CECILE (MD)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:CECILE
Last Name:SANGSTER SADAPHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:CECILE
Other - Last Name:SANGSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:44 GEORGIA STREET,
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580
Mailing Address - Country:US
Mailing Address - Phone:516-285-4384
Mailing Address - Fax:516-285-1909
Practice Address - Street 1:44 GEORGIA STREET,
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580
Practice Address - Country:US
Practice Address - Phone:516-285-4384
Practice Address - Fax:516-285-1909
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166066208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice