Dr. Sandra Sirada Jaroonwanichkul, MD
Student in an Organized Health Care Education/Training Program in Staten Island, NY. Individual provider (NPI-1).
NPI number1750277331
StatusActive
Last updated in NPPESJun 17, 2025
Details
- NPI
- 1750277331
- Entity type
- Individual (NPI-1)
- Name
- Dr. Sandra Sirada Jaroonwanichkul
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 17, 2025
- Certification date
- Jun 17, 2025
- Last updated
- Jun 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
355 Bard AvenueDepartment Of Medicine Villa Bldg 1st Floor
Staten Island, NY 10310
Phone 718-818-2419
Mailing address
355 Bard AvenueDepartment Of Medicine Villa Bldg 1st Floor
Staten Island, NY 10310
Phone 718-818-2419
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