Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 003017 | NY |
NPI | 1639347537 |
---|---|
Provider Name | Dr. Pedro Rodrigo Sandoval |
First Address | New York, NY 10032-3720 |
Second Address | New York, NY 10032-3720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 30/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03052655 | (05) | NY |