Provider Demographics
NPI:1396593083
Name:SANDEL PRIMARY CARE PLLC
Entity type:Organization
Organization Name:SANDEL PRIMARY CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:SANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:518-217-8199
Mailing Address - Street 1:3991 NY-2
Mailing Address - Street 2:STE 15
Mailing Address - City:CROPSEYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12052
Mailing Address - Country:US
Mailing Address - Phone:518-217-8199
Mailing Address - Fax:678-737-1094
Practice Address - Street 1:3991 NY-2. STE 15
Practice Address - Street 2:
Practice Address - City:CROPSEYVILLE
Practice Address - State:NY
Practice Address - Zip Code:12052
Practice Address - Country:US
Practice Address - Phone:518-217-8199
Practice Address - Fax:678-737-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty