Individual
MARK J. SANDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-5400
(631) 444-7538
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
235234
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2062780
—
OH
Enumeration date
04/19/2006
Last updated
12/05/2018
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