Basic Information
Provider Information
NPI: 1033474374
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANZ SALVO
FirstName: ANGEL
MiddleName: JAVIER
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SANZ
OtherFirstName: JAVIER
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 2
Mailing Information
Address1: 1 GUSTAVE L LEVY PL
Address2: BOX 3000
City: NEW YORK
State: NY
PostalCode: 100296500
CountryCode: US
TelephoneNumber: 2129873100
FaxNumber: 2127315210
Practice Location
Address1: 1428 MADISON AVE
Address2: 8TH FLOOR
City: NEW YORK
State: NY
PostalCode: 100296508
CountryCode: US
TelephoneNumber: 2124271540
FaxNumber: 2124107196
Other Information
ProviderEnumerationDate: 07/12/2012
LastUpdateDate: 08/30/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X265571NYY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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