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Individual

JAY B SANDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1818 AMHERST ST, WINCHESTER, VA 22601-2869
(540) 450-0072
(540) 450-0074
Mailing address
1818 AMHERST ST, WINCHESTER, VA 22601-2869
(540) 450-0072
(540) 450-0074

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0017137339
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215917414
VA
05
7102150000
WV
01
P00657233
MEDICARE RR
VA
Enumeration date
01/23/2006
Last updated
02/10/2009
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