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Organization
SANJAY SASTRY MD PA
Active
Organization
SANJAY SASTRY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY SASTRY MD (OWNER)
(407) 280-3630
Entity
Organization
Contact information
Practice address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 423-5500
Mailing address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 423-5500
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
NULL
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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