Individual
SANDRA L ESCANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
633 RTE 37 W, TOMS RIVER, NJ 08755-8007
(732) 240-4787
(732) 240-3114
Mailing address
633 RTE 37 W, TOMS RIVER, NJ 08755-8007
(732) 240-4787
(732) 240-3114
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA04195700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
519171
AETNA
NJ
05
—
6533507
—
NJ
Enumeration date
05/02/2006
Last updated
07/08/2007
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