Dr. Sandra Phan, O.D.
Optometrist in Jackson Heights, NY. Individual provider (NPI-1).
NPI number1760635510
StatusActive
Last updated in NPPESNov 3, 2020
Details
- NPI
- 1760635510
- Entity type
- Individual (NPI-1)
- Name
- Dr. Sandra Phan
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 24, 2008
- Certification date
- Nov 3, 2020
- Last updated
- Nov 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 046010174 | IL | Yes |
Practice location
8407 Roosevelt AveJackson Heights, NY 11372-7340
Phone 718-651-2020 · Fax 718-651-2034
Mailing address
8407 Roosevelt AveJackson Heights, NY 11372-7340
Phone 718-651-2020 · Fax 718-651-2034
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