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Organization
SANDERSON MEDICAL PC
Active
Organization
SANDERSON MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRGIL THOMAS SANDERSON MD (PRESIDENT)
(718) 523-7186
Entity
Organization
Contact information
Practice address
8515 MAIN ST, BRIARWOOD, NY 11435-1849
(718) 523-7186
Mailing address
8515 MAIN ST, BRIARWOOD, NY 11435-1849
(718) 523-7186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
168193
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01000908
—
NY
Enumeration date
09/24/2007
Last updated
04/20/2008
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