Individual
JUAN SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9413 FLATLANDS AVE, SUITE 206E, BROOKLYN, NY 11236
(718) 485-2420
Mailing address
2 BARNES LN, GARDEN CITY, NY 11530-4402
(718) 485-2420
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
235394
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01981093
—
NY
Enumeration date
01/19/2006
Last updated
06/28/2019
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