Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 25MA06068400 | NJ |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 25MA06068400 | NJ |
NPI | 1255302915 |
---|---|
Provider Name | Matthew Sandler |
First Address | Marlton, NJ 08053-4197 |
Second Address | Cherry Hill, NJ 08034-2600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7420803 | (05) | NJ |
F88974 | (02) |