| O E Sandoval Md Pc | |
|
569 35th St Union City NJ 07087-2563 | |
| (201) 866-6970 | |
| (201) 866-7144 |
| Full Name | O E Sandoval Md Pc |
|---|---|
| Speciality | Counselor |
| Location | 569 35th St, Union City, New Jersey |
| Authorized Official Name and Position | Oscar E Sandoval (DIRECTOR) |
| Authorized Official Contact | 2018669670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| O E Sandoval Md Pc 569 35th St Union City NJ 07087-2563 Ph: (201) 866-6970 | O E Sandoval Md Pc 569 35th St Union City NJ 07087-2563 Ph: (201) 866-6970 |
| NPI Number | 1902250913 |
|---|---|
| Provider Enumeration Date | 04/15/2016 |
| Last Update Date | 04/15/2016 |
| Medicare PECOS PAC ID | 9133428667 |
|---|---|
| Medicare Enrollment ID | O20160504001082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902250913 | NPI | - | NPPES |
| 3585905 | Medicaid | NJ | |
| 25MA045843 | Other | NJ | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Oscar E Sandoval Castellanos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811945595 PECOS PAC ID: 4880606706 Enrollment ID: I20060614000312 |
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