Individual
JEFFREY DAVID SANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2233 CECIL B MOORE AVE, PHILADELPHIA, PA 19121-4025
(215) 765-0873
(610) 446-6543
Mailing address
508 SAINT ALBANS RD, HAVERTOWN, PA 19083-5605
(610) 446-6543
(610) 446-6543
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC-002493-L
PA
213EP1101X
Primary Podiatric Medicine Podiatrist
SC-002493-L
PA
213ES0000X
Sports Medicine Podiatrist
SC-002493-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000902603001
—
PA
01
—
00431158
BLUE SHIELD ID
PA
01
—
0060805000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
06/07/2006
Last updated
10/18/2013
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