Provider Demographics
NPI:1497598619
Name:SANCHEZ, JOMAIRA
Entity type:Individual
Prefix:
First Name:JOMAIRA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 MONTAUK HWY APT 3A
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-4934
Mailing Address - Country:US
Mailing Address - Phone:929-293-4427
Mailing Address - Fax:
Practice Address - Street 1:840 MONTAUK HWY APT 3A
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-4934
Practice Address - Country:US
Practice Address - Phone:929-293-4427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-15
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker