Provider Demographics
NPI:1487917936
Name:SANCHEZ, JAIME (MSED)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 E 211TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1668
Mailing Address - Country:US
Mailing Address - Phone:646-671-4632
Mailing Address - Fax:
Practice Address - Street 1:288 E 211TH ST APT 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1668
Practice Address - Country:US
Practice Address - Phone:646-671-4632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist